CommercialMedicare AdvantageJanuary 1, 2024

January 2024 Provider Newsletter

Featured Articles

Digital SolutionsCommercialDecember 26, 2023

Training for digital requests for additional information (Digital RFAI)

Education & TrainingCommercialJanuary 1, 2024

Important information about your Anthem patients’ specialty prescriptions

Quality ManagementCommercialNovember 20, 2023

Annual preventive care visits


Administrative

AdministrativeCommercialJanuary 1, 2024

Using and billing air ambulance services appropriately

AdministrativeCommercialJanuary 1, 2024

CAA: Maintain your online provider directory information

AdministrativeMedicare AdvantageJanuary 1, 2024

Inappropriate primary diagnosis

AdministrativeCommercialJanuary 1, 2024

Drug fee schedule update

Policy Updates

Medical Policy & Clinical GuidelinesCommercialDecember 19, 2023

Adopted Clinical Guidelines as of: January 1, 2024

Medical Policy & Clinical GuidelinesCommercialJanuary 1, 2024

Material adverse change

Medical Policies and Clinical Guidelines notification letter

Medical Policy & Clinical GuidelinesMedicare AdvantageDecember 1, 2023

Clinical Criteria updates — August 2023

Medical Policy & Clinical GuidelinesMedicare AdvantageJanuary 1, 2024

Genetic testing code list update

Medical Policy & Clinical GuidelinesCommercialJanuary 1, 2024

Material adverse change

Carelon Medical Benefits Management, Inc. genetic testing CPT® code list update

Medical Policy & Clinical GuidelinesCommercialDecember 28, 2023

Material adverse change

Transition to Carelon Medical Benefits Management, Inc. cardiology guidelines

Medical Policy & Clinical GuidelinesMedicare AdvantageDecember 28, 2023

Transition to Carelon Medical Benefits Management, Inc. cardiology guidelines

Medical Policy & Clinical GuidelinesMedicare AdvantageJanuary 1, 2024

Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness Guidelines

Medical Policy & Clinical GuidelinesCommercialJanuary 1, 2024

Material adverse change

Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness Guidelines

Prior AuthorizationCommercialJanuary 1, 2024

Material adverse change

Expansion of Carelon Medical Benefits Management programs

Prior AuthorizationMedicare AdvantageJanuary 10, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs effective April 1, 2024

Products & Programs

DentalCommercialJanuary 1, 2024

January Dental newsletter communications

PharmacyCommercialJanuary 1, 2024

Material adverse change

Prior authorization updates for specialty pharmacy

Quality Management

Quality ManagementMedicare AdvantageJanuary 1, 2024

Boost annual planned visit rates

Quality ManagementCommercialMedicare AdvantageJanuary 1, 2024

HEDIS diabetes documentation

COBCBS-CRCM-047200-23

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