Key Updates
CommercialMedicare AdvantageNovember 1, 2024
Roster Automation updates: roster download functionality
CommercialMedicare AdvantageOctober 24, 2024
Time to prepare for HEDIS medical record review
CommercialOctober 23, 2024
Do you offer telehealth services? Let us know!
Medicare AdvantageOctober 15, 2024
Model of Care training reminder
Recent Updates
CommercialNovember 21, 2024
Expansion of Carelon Medical Benefits Management, Inc. programsMedicare AdvantageNovember 18, 2024
Expansion of Carelon Medical Benefits Management, Inc. programsMedicare AdvantageNovember 18, 2024
Notice of change: Part D Rx HCCsMedicare AdvantageNovember 15, 2024
Skilled nursing facility — vaccine serum compensationMedicare AdvantageNovember 15, 2024
Colorado 2025 Medicare Advantage plan changesMedicare AdvantageNovember 14, 2024
Medicare Part D overhaul: What's new in 2025 for your prescription drug costs?CommercialMedicare AdvantageNovember 1, 2024
Roster Automation updates: roster download functionalityCommercialNovember 1, 2024
High Performing and Blue National Designated Providers may also be known as Anthem Diamond ProvidersCommercialNovember 1, 2024
Adopting digital member ID cardsCommercialNovember 1, 2024
New claims requirement: add-on codes must include primary procedure starting December 2024CommercialNovember 1, 2024
Material adverse change
Precertification List Change Notification — November 1, 2024CommercialNovember 1, 2024
Reimbursement policy reminder: Multiple Surgery — FacilityCommercialNovember 1, 2024
Material adverse change
Reimbursement policy update: Nurse Practitioner and Physician Assistant ServicesCommercialNovember 1, 2024
Material adverse change
Precertification List Change Notification — November 1, 2024Codes J3393 and J3394
Medicare AdvantageNovember 1, 2024
Improving patient outcomes: back to the basicsMedicare AdvantageMedicaidOctober 29, 2024
HEDIS Measure Tips — Appropriate Treatment for Upper Respiratory Infection (URI) 2025CommercialMedicare AdvantageOctober 24, 2024
Time to prepare for HEDIS medical record reviewCommercialMedicare AdvantageOctober 23, 2024
HEDIS Measure Tips — Appropriate Testing for Pharyngitis (CWP) 2025CommercialOctober 23, 2024
Do you offer telehealth services? Let us know!CommercialMedicare AdvantageOctober 22, 2024
HEDIS Measure Tips — Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB) 2025Medicare AdvantageOctober 16, 2024
Clarification to Carelon Medical Benefits Management, Inc. updates effective September 1, 2024Medicare AdvantageOctober 15, 2024
Model of Care training reminderCommercialMedicare AdvantageOctober 7, 2024
HEDIS Measure Tips — Cardiac Rehabilitation (CRE) 2025Medicare AdvantageOctober 4, 2024
HEDIS Measure Tips — Adults’ Access to Preventive/Ambulatory Health Services (AAP) 2025CommercialMedicare AdvantageOctober 3, 2024
Blood Pressure Control for Patients With Diabetes (BPD) 2025Medicare AdvantageOctober 2, 2024
Pharmacotherapy Management of COPD Exacerbation (PCE) 2025CommercialOctober 1, 2024
National Accounts 2025 precertification listCommercialOctober 1, 2024
Drug fee schedule updateCommercialOctober 1, 2024
Introduction of the HPP designation program for individual member (Exchange) networksCommercialMedicare AdvantageOctober 1, 2024
HEDIS medical record submission made easier with our Remote EMR Access serviceCommercialOctober 1, 2024
Pharmacy information available on our provider websiteCommercialOctober 1, 2024
Material adverse change
Prior authorization updates for specialty pharmacy — October 2024CommercialOctober 1, 2024
Material adverse change
Reimbursement policy update: Modifiers 59 and XE, XP, XS, and XU: Distinct Procedural Service — ProfessionalMedicare AdvantageOctober 1, 2024
Clarification to reimbursement policy update: Nurse Practitioner and Physician Assistant ServicesCommercialOctober 1, 2024
Provider manual update availableMedicare AdvantageOctober 1, 2024
Introducing the Care Provider Recognition Program from AnthemMedicare AdvantageOctober 1, 2024
Medicare Part D overhaul: What's new in 2025 for your prescription drug costs?CommercialMedicare AdvantageOctober 1, 2024
Prevent flu and COVID-19: drive the change through vaccinationMedicare AdvantageSeptember 25, 2024
Carelon Medical Benefits Management, Inc. updatesEffective October 26, 2024
Medicare AdvantageSeptember 24, 2024
Prior authorization requirement changesEffective February 1, 2025
Medicare AdvantageSeptember 23, 2024
Prior authorization requirement changesEffective January 1, 2025
Medicare AdvantageSeptember 23, 2024
Osteoporosis Management in Women Who Had a Fracture (OMW) 2025Medicare AdvantageSeptember 19, 2024
HEDIS Measure Tips — Osteoporosis Screening in Older Women (OSW) 2025Medicare AdvantageSeptember 16, 2024
Seamless advance care: MyDirectives digital tool for D-SNP membersCommercialMedicare AdvantageSeptember 12, 2024
Roster Automation updates effective November 15, 2024: enhanced reporting to increase data accuracyMedicare AdvantageSeptember 10, 2024
Medical Policies and Clinical Utilization Management Guidelines updateEffective October 10, 2024
CommercialMedicare AdvantageSeptember 4, 2024
Digital Provider Enrollment now available for additional provider types in Availity Essentials