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Medicare AdvantageMay 1, 2023
Keep up with Medicare news - May 2023- Home health, claims payment, and provider network services for Anthem Blue Cross and Blue Shield individual members delegated to Carelon Post Acute Solutions
- Itemized bill review program
- Medical Policiesand Clinical Utilization Management Guidelines update
Medicare AdvantageMay 1, 2023
Genetic testingMedicare AdvantageMay 1, 2023
Did your patient have a recent fracture?Medicare AdvantageMarch 31, 2023
Keep up with Medicare news - April 2023- Genetic testing CPT code list update for Carelon Medical Benefits Management (formerly AIM Specialty Health)
- Clinical Criteria updates
- Clinical Criteria updates
- Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list
- Blue Cross and Blue Shield expands specialty pharmacy precertification list
- New specialty pharmacy medical step therapy requirements
Medicare AdvantageMarch 31, 2023
E-visitsMedicare AdvantageMarch 1, 2023
Keep up with Medicare news - March 2023- Update: Carelon Medical Benefits Management, Inc. Cardiology Clinical Appropriateness Guidelines CPT Code List in Colorado
- Carelon Medical Benefits Management, Inc. Genetic Testing Clinical Appropriateness Guidelines CPT code list update
- What date to select for inpatient admissions for claims
- Clinical Criteria updates
- New specialty pharmacy medical step therapy requirements
- Updates to Carelon Medical Benefits Management, Inc. Cardiac Clinical Appropriateness Guidelines
Medicare AdvantageMarch 1, 2023
Shared savings and transition care management after inpatient dischargesMedicare AdvantageMarch 1, 2023
Informational Update Modifier UsageMedicare AdvantageMarch 1, 2023
Annual planned visitsMedicare AdvantageJanuary 31, 2023
Name change announcement: myNEXUS will transition to Carelon Post Acute Solutions on March 1, 2023Medicare AdvantageJanuary 31, 2023
Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness GuidelinesMedicare AdvantageJanuary 31, 2023
AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List update (MAC)Material adverse change (MAC)
Medicare AdvantageJanuary 31, 2023
Keep up with Medicare news - February 2023- Updates to AIM Specialty Health Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines
- Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines — Colorado
- Updates to AIM Specialty Health Musculoskeletal — Interventional Pain Management Clinical Appropriateness Guidelines
- Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list (Fylnetra)
- Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list (Spevigo, Xenpozyme)
- Specialty pharmacy precertification list expansion (Rolvedon, Stimufend)
- New specialty pharmacy medical step therapy requirements
- Prior authorization requirement changes effective April 1, 2023
- Medical Policies and Clinical Utilization Management Guidelines update
Medicare AdvantageDecember 30, 2022
Updates to AIM Specialty Health Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines (MAC)Material adverse change (MAC)
Medicare AdvantageDecember 30, 2022
Keep up with Medicare news - January 2023Medicare AdvantageDecember 30, 2022
Notification regarding reimbursement changes to COVID-19 laboratory services codesMedicare AdvantageDecember 1, 2022
Personal home helper benefit endingMedicare AdvantageDecember 1, 2022
2023 Medicare Advantage service area and benefit updatesMedicare AdvantageDecember 1, 2022
Keep up with Medicare news - December 2022Medicare AdvantageNovember 1, 2022
Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification listMedicare AdvantageNovember 1, 2022
Keep up with Medicare news - November 2022- Medical drug benefit Clinical Criteria updates
- New specialty pharmacy medical step therapy requirements (Acastin, Mvasi)
- New specialty pharmacy medical step therapy requirements (Zarxio)
Medicare AdvantageOctober 1, 2022
Keep up with Medicare news - October 2022Medicare AdvantageOctober 1, 2022
Reimbursement policy retraction: Sexually Transmitted Infections Testing - professionalMedicare AdvantageOctober 1, 2022
Courtesy notification of specialty pharmacy medical step therapy updatesMedicare AdvantageOctober 1, 2022
Medicare telehealth services during the Coronavirus (COVID-19) public health emergency (PHE) FAQMedicare AdvantageAugust 31, 2022
Keep up with Medicare news – September 2022Medicare AdvantageAugust 31, 2022
Anthem Blue Cross and Blue Shield to accept Hospital in Home servicesMedicare AdvantageAugust 31, 2022
Anthem Blue Cross and Blue Shield Expands Specialty Pharmacy Precertification listMedicare AdvantageAugust 31, 2022
Reimbursement policy update: Modifiers 25 and 57 Evaluation and Management with Global ProceduresMedicare AdvantageAugust 31, 2022
Enhancing claims attachment processes through digital applicationsMedicare AdvantageAugust 31, 2022
Reminder: AIM prior authorization phone number change for MedicareMedicare AdvantageAugust 31, 2022
Prior authorization requirement changes effective December 1, 2022Medicare AdvantageAugust 1, 2022
Keep up with Medicare news – August 2022Medicare AdvantageJuly 1, 2022
Keep up with Medicare news – July 2022Medicare AdvantageJuly 1, 2022
Cancer Care NavigatorMedicare AdvantageJune 1, 2022
Keep up with Medicare news – June 2022- Updates to AIM Specialty Health Sleep Disorder Management Clinical Appropriateness Guidelines
- New specialty pharmacy medical step therapy requirements
- Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list
- Updates to AIM Specialty Health Musculoskeletal Clinical Appropriateness Guidelines
Medicare AdvantageJune 1, 2022
Provider notice for COVID-19 testingMedicare AdvantageJune 1, 2022
Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness GuidelinesMedicare AdvantageJune 1, 2022
Medical policies and clinical utilization Management guidelines updateMedicare AdvantageJune 1, 2022
Medical drug benefit Clinical Criteria updatesMedicare AdvantageMay 1, 2022
New specialty pharmacy medical step therapy requirementsMedicare AdvantageMay 1, 2022
New Strategic Provider System implementation May 2022Medicare AdvantageMay 1, 2022
Convenient, reliable at-home testing for colorectal cancer and diabetes careMedicare AdvantageApril 1, 2022
Keep up with Medicare news – April 2022- Medical Policies and Clinical Utilization Management Guidelines update
- Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list
- AIM Specialty Health Outpatient Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines updates
- Quick tips to filing a complete and correct professional claim
Medicare AdvantageApril 1, 2022
Model of Care required training