CommercialMedicare AdvantageFebruary 1, 2025

February 2025 Provider Newsletter

Administrative

AdministrativeCommercialJanuary 16, 2025

Submitting authorization for NICU services facilitates accurate and timely claims processing

AdministrativeCommercialFebruary 1, 2025

Material adverse change

Medical records needed for accurate payment of certain facility inpatient claims

AdministrativeCommercialMedicare AdvantageFebruary 1, 2025

New Communication Center added to Availity Essentials

AdministrativeCommercialJanuary 30, 2025

CMS reveals 2025 Q1 drug pricing: key changes effective February 1st

Education & Training

Education & TrainingCommercialMedicare AdvantageJanuary 1, 2025

Enhance billing and coding accuracy with new Payment Integrity training

Policy Updates

Medical Policy & Clinical GuidelinesCommercialFebruary 1, 2025

Material adverse change

Clinical UM Guidelines notification letter

Reimbursement PoliciesCommercialFebruary 1, 2025

New reimbursement policy: Place of Service — Professional

Reimbursement PoliciesCommercialFebruary 1, 2025

Material adverse change

Reimbursement policy update: Diagnostic Radiopharmaceuticals and Contrast Materials — Professional and Facility

Products & Programs

Federal Employee Program (FEP)CommercialFebruary 1, 2025

Corrected claim guidance for the Federal Employee Program®

Federal Employee Program (FEP)CommercialJanuary 14, 2025

Authorization for post‑acute care services for FEP members

PharmacyCommercialFebruary 1, 2025

Designated specialty pharmacy network updates

PharmacyCommercialFebruary 1, 2025

Pharmacy information available on our provider website

PharmacyCommercialJanuary 27, 2025

Key formulary updates: effective January 1, 2025

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)

COBCBS-CRCM-076683-25