November 1, 2024

November 2024 Provider Newsletter

Filter By: AllCommercialMedicare AdvantageMedicaid

Featured Articles

Education & TrainingMedicaidSeptember 27, 2024

Provider notification process

Education & TrainingMedicare AdvantageOctober 15, 2024

Model of Care training reminder

Quality ManagementCommercialMedicare AdvantageMedicaidOctober 24, 2024

Time to prepare for HEDIS medical record review

AdministrativeCommercialOctober 23, 2024

Do you offer telehealth services? Let us know!

Administrative

AdministrativeMedicaidOctober 23, 2024

Federal and state law prohibit providers from balance billing Medi-Cal Managed Care beneficiaries

AdministrativeMedicaidNovember 1, 2024

Community Supports services: cost-effective alternatives for eligible members

AdministrativeCommercialNovember 1, 2024

Welcome to the Pathway HMO Network

AdministrativeCommercialMedicaidMarch 4, 2024

Access to care standards

AdministrativeCommercialNovember 1, 2024

More error types for corrected claims submitted through EDI now available

AdministrativeCommercialNovember 1, 2024

Personalized Match update

Policy Updates

Policy UpdatesCommercialOctober 9, 2024

Provider transparency update

Policy UpdatesMedicaidOctober 18, 2024

Child Health and Disability Prevention program phased out to streamline services under the CalAIM initiative

Policy UpdatesMedicare AdvantageOctober 16, 2024

Clarification to Carelon Medical Benefits Management, Inc. updates effective September 1, 2024

Policy UpdatesMedicaidOctober 2, 2024

Clarification to Carelon Medical Benefits Management, Inc. updates effective September 1, 2024

Policy UpdatesMedicare AdvantageSeptember 25, 2024

Carelon Medical Benefits Management, Inc. updates

Effective November 17, 2024

Policy UpdatesMedicaidSeptember 30, 2024

Carelon Medical Benefits Management, Inc. updates

Effective January 30, 2025

Medical Policy & Clinical GuidelinesMedicare AdvantageOctober 18, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Effective November 23, 2024

Medical Policy & Clinical GuidelinesMedicaidSeptember 24, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Effective December 26, 2024

Prior AuthorizationMedicaidOctober 10, 2024

Prior authorization requirement changes

Effective February 1, 2025

Prior AuthorizationMedicare AdvantageSeptember 24, 2024

Prior authorization requirement changes

Effective February 1, 2025

Products & Programs

PharmacyMedicaidNovember 1, 2024

Bayer announces withdrawal of Aliqopa® (copanlisib)

PharmacyMedicare AdvantageNovember 1, 2024

Improving patient outcomes: back to the basics

Quality Management

Quality ManagementMedicaidOctober 24, 2024

Provider: CAHPS awareness

CABC-CDCRCM-070441-24

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