May 1, 2025
May 2025 Provider Newsletter
Filter By: AllCommercialMedicare AdvantageMedicaid
Featured Articles
Medicare AdvantageApril 29, 2025
Join our D-SNP network to better serve dual-eligible patients
MedicaidMay 1, 2025
Join our medical committee to help shape healthcare innovations
Administrative
CommercialMay 1, 2025
Direct HMO: Understanding the network designCommercialMedicaidApril 29, 2025
Ensuring timely attention to expedited grievances and appealsCommercialMay 1, 2025
Unlock the power of electronic claims with Availity EssentialsCommercialMay 1, 2025
Annual grievance and appeals attestation requirementCommercialMedicare AdvantageMedicaidMay 1, 2025
Reminder: New Communication Center added to Availity EssentialsEducation & Training
CommercialMay 1, 2025
Free CE training: Lifestyle Medicine & Food as Medicine Essentials CourseCommercialMay 1, 2025
Streamline your prior authorizations with our digital toolsCommercialMay 1, 2025
Effortless eligibility checks with the Patient Search Option in AvailityMedicaidMay 1, 2025
Enhancing your learning experience: latest updates in Provider PathwaysPolicy Updates
Medicare AdvantageApril 24, 2025
Medical Policies and Clinical Utilization Management Guidelines updateEffective May 25, 2025
MedicaidApril 1, 2025
Medical Policies and Clinical Utilization Management Guidelines updateEffective July 1, 2025
Medicare AdvantageApril 30, 2025
Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness GuidelinesEffective August 1, 2025
MedicaidApril 4, 2025
Precertification/prior authorization requirement changesEffective August 1, 2025
Products & Programs
Medicare AdvantageApril 16, 2025
New specialty pharmacy medical step therapy requirementEffective June 1, 2025
Hercessi
Medicare AdvantageApril 16, 2025
Specialty pharmacy preapproval list updateEffective August 1, 2025
Jubbonti; Wyost
CABC-CDCRCM-081381-25-CPN81360
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