July 1, 2025

July 2025 Provider Newsletter

Filter By: AllCommercialMedicare Advantage

Featured Articles

WebinarsCommercialMedicare AdvantageJuly 1, 2025

Join the 2025 Clinical Quality in Practice webinar series

AdministrativeCommercialJuly 1, 2025

Enroll with Availity to verify your provider data

Administrative

AdministrativeMedicare AdvantageJuly 1, 2025

Implementation of chargemaster‑based claims edit for ER leveling

AdministrativeCommercialJuly 1, 2025

A quick guide to understanding JW and JZ modifiers

AdministrativeMedicare AdvantageJuly 1, 2025

A quick guide to understanding JW and JZ modifiers

AdministrativeMedicare AdvantageJune 23, 2025

Essential information for providers: understanding Medicare Advantage group retiree plans

AdministrativeCommercialJuly 1, 2025

CMS drug fee schedule update effective August 1, 2025

AdministrativeCommercialJuly 1, 2025

Update: essential ICD‑10‑CM compliance for outpatient facility claims

Digital SolutionsCommercialMedicare AdvantageJuly 1, 2025

Seamless Provider Enrollment and Network Management through Availity Essentials optimizes the care provider experience

Digital SolutionsCommercialMedicare AdvantageJuly 1, 2025

Streamlining behavioral health authorizations via Availity Essentials

Digital SolutionsMedicare AdvantageJune 17, 2025

Specialty pharmacy precertification list expansion — key updates

Education & Training

Education & TrainingMedicare AdvantageJuly 1, 2025

Combat diabetes: Close the statin therapy gap for better heart health

Policy Updates

Policy UpdatesCommercialJuly 1, 2025

Material adverse change

Clinical UM Guidelines updates

Policy UpdatesCommercialJuly 1, 2025

Readmission review process change

Policy UpdatesMedicare AdvantageJune 2, 2025

Clinical Criteria updates

Effective July 6, 2025

Prior AuthorizationCommercialJuly 1, 2025

Material adverse change

Precertification/prior authorization list change notification July 1, 2025

Reimbursement PoliciesCommercialJuly 1, 2025

Material adverse change

New reimbursement policy: Code and Clinical Editing Guidelines – Professional and Facility

Reimbursement PoliciesCommercialJuly 1, 2025

Material adverse change

Reimbursement policy update: Bundled Services and Supplies – Professional

Reimbursement PoliciesCommercialJuly 1, 2025

Reimbursement policy update: Nurse Practitioner and Physician Assistant services

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