CommercialMedicare AdvantageSeptember 1, 2023
September 2023 Provider Newsletter
Featured Articles
CommercialSeptember 1, 2023
HCPCS to revenue code alignment
Medicare AdvantageSeptember 1, 2023
Reminder: Review the health reimbursement arrangement and care plan updates in Availity Essentials
Administrative
CommercialSeptember 1, 2023
CAA: Have you reviewed your online provider directory information lately?CommercialSeptember 1, 2023
Support documentation for Carelon Medical Benefits Management, Inc. prior authorization requestsCommercialSeptember 1, 2023
Update — Enhanced outpatient facility editing for National Correct Coding InitiativeCommercialSeptember 1, 2023
Consider a FIT kit for your patients aged 45 and older at average risk for colon cancerCommercialJuly 27, 2023
Help your patients continue their care and navigate Medicaid renewalCommercialSeptember 1, 2023
Improvements to Digital RFAI Attachment filtering and reportingCommercialSeptember 1, 2023
Member search feature enhancement: Search for a patient without using member ID in Availity EssentialsMedicare AdvantageSeptember 1, 2023
Personalized match phase 1: Specialist provider overviewCommercialSeptember 1, 2023
Simplifying claims attachments: Digital Request for Additional Information through Availity.comCommercialMedicare AdvantageAugust 14, 2023
Changes to our data management system will help streamline your demographic update processEducation & Training
CommercialMedicare AdvantageJuly 10, 2023
You're invited: Thriving, not just surviving: Youth mental health in today's worldPolicy Updates
Medicare AdvantageAugust 14, 2023
Clinical Criteria updates - May 2023Medicare AdvantageAugust 7, 2023
Prior authorization requirement changes effective December 1, 2023Medicare AdvantageMay 24, 2023
Carelon Medical Benefits Management, Inc. advanced imaging — Imaging of the brain CPT code list updateCommercialSeptember 1, 2023
Material adverse change
Carelon Medical Benefits Management, Inc. Advanced Imaging - Imaging of the Brain CPT Code List update (MAC)
CommercialSeptember 1, 2023
Material adverse change
Reimbursement policy update: Documentation Standards for Episodes of Care — ProfessionalCommercialSeptember 1, 2023
Clarification to reimbursement policy update: Prolonged Services – ProfessionalCommercialSeptember 1, 2023
Reimbursement policy update: Documentation and Reporting Guidelines for Evaluation and Management Services - ProfessionalCommercialSeptember 1, 2023
New reimbursement policy: Split Care Surgical Modifiers — ProfessionalProducts & Programs
CommercialSeptember 1, 2023
Sublocade® updateMedicare AdvantageAugust 3, 2023
Specialty pharmacy medical step therapy for hyaluronan injectionsMedicare AdvantageJuly 28, 2023
UPDATED: Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification listQuality Management
Medicare AdvantageSeptember 1, 2023
Medication reconciliation post inpatient dischargeCOBCBS-CRCM-035537-23
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