CommercialMedicare AdvantageMedicaidSeptember 1, 2024

September 2024 Provider Newsletter

Featured Articles

Digital SolutionsCommercialMedicare AdvantageMedicaidAugust 27, 2024

Maximizing care with regular provider data attestation

AdministrativeCommercialMedicare AdvantageMedicaidAugust 1, 2023

Clinical Laboratory Improvement Amendments


Administrative

AdministrativeMedicaidSeptember 1, 2024

Doula Program

AdministrativeMedicaidSeptember 1, 2024

Drug and biologic

AdministrativeMedicaidSeptember 1, 2024

Discover the latest updates to the Provider Operations Manual

AdministrativeMedicare AdvantageSeptember 1, 2024

Enhanced claims edits for FDA-approved drug codes

AdministrativeCommercialSeptember 1, 2024

Enhanced outpatient facility editing for NCCI: MUE

Digital SolutionsCommercialMedicare AdvantageMedicaidSeptember 1, 2024

Save time and get better results with optimized CPT code search in Availity Essentials

Education & Training

Education & TrainingCommercialSeptember 1, 2024

New provider resource for family caregivers of members with cancer

Policy Updates

Policy UpdatesMedicaidJuly 24, 2024

Clinical Criteria updates

Effective October 25, 2024

Medical Policy & Clinical GuidelinesMedicaidAugust 6, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Effective November 14, 2024

Prior AuthorizationMedicare AdvantageJuly 31, 2024

Prior authorization requirement changes

Effective December 1, 2024

Prior AuthorizationMedicaidAugust 5, 2024

Prior authorization requirement changes

Effective December 1, 2024
Codes: 33263, 64582, and C2616

Products & Programs

Long-Term Services & SupportsCommercialSeptember 1, 2024

The Power of the Blues: Introducing the Blue National Physician Performance Dataset

PharmacyMedicare AdvantageAugust 12, 2024

Anthem expands specialty pharmacy precertification list

Code: J1599

PharmacyMedicare AdvantageAugust 27, 2024

Anthem expands specialty pharmacy precertification list

Codes: C9399, J9999 and J3590

PharmacyMedicare AdvantageSeptember 1, 2024

Real-time prescription benefit

PharmacyCommercialSeptember 1, 2024

Pharmacy information available on our provider website

Quality Management

Quality ManagementCommercialMedicare AdvantageAugust 13, 2024

Announcing the new HEDIS documentation library supporting coding excellence

CABC-CDCRCM-065267-24

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).