February 1, 2025

February 2025 Provider Newsletter

Filter By: AllCommercialMedicare AdvantageMedicaid

Featured Articles

Education & TrainingMedicaidFebruary 1, 2025

Medi‑Cal Managed Care for Kids & Teens provider training

Administrative

AdministrativeCommercialJanuary 16, 2025

Submitting authorization for NICU services facilitates accurate and timely claims processing

AdministrativeCommercialMedicare AdvantageMedicaidFebruary 1, 2025

New Communication Center added to Availity Essentials

Education & Training

Education & TrainingCommercialMedicare AdvantageMedicaidJanuary 1, 2025

Enhance billing and coding accuracy with new Payment Integrity training

Products & Programs

Federal Employee Program (FEP)CommercialFebruary 1, 2025

Corrected claim guidance for the Federal Employee Program®

PharmacyCommercialFebruary 1, 2025

Pharmacy information available on our website

PharmacyCommercialJanuary 27, 2025

Key formulary updates: effective January 1, 2025

PharmacyMedicaidJanuary 3, 2025

Prior authorization updates for medications billed under the medical benefit

Effective May 1, 2025
Alyglo, Simlandi, and Winrevair

PharmacyMedicaidJanuary 7, 2025

Prior authorization updates for medications billed under the medical benefit

Effective May 1, 2025
Kisunla and Piasky

PharmacyMedicaidJanuary 8, 2025

New specialty pharmacy medical step therapy requirements

PharmacyCommercialFebruary 1, 2025

Action required for HMO medical groups — submit HMO ancillary information

PharmacyCommercialJanuary 15, 2025

Weight management program overview

Quality Management

Quality ManagementCommercialMedicare AdvantageFebruary 1, 2025

2025 Clinical Quality in Practice webinar series

Quality ManagementCommercialFebruary 1, 2025

Avoidance of Antibiotics Treatment for Acute Bronchitis/Bronchiolitis (AAB)

CABC-CDCRCM-076682-25