Key Updates
CommercialMedicare AdvantageAugust 1, 2025
You are invited: immunization measures webinar
CommercialMedicare AdvantageJuly 23, 2025
Enhance care provider data accuracy with updated roster tools
Recent Updates
Medicare AdvantageAugust 1, 2025
Expanded specialty pharmacy precertification listCommercialAugust 1, 2025
SUD confidentiality protections for membersCommercialAugust 1, 2025
Support your patients with the CarelonRx, Inc. and Lark Weight Management ProgramCommercialMedicare AdvantageAugust 1, 2025
You are invited: immunization measures webinarCommercialAugust 1, 2025
Material adverse change
Diagnostic Radiopharmaceuticals and Contrast Materials — Professional and Facility updateCommercialMedicare AdvantageAugust 1, 2025
Compatibility in care: sharing REL data to improve member healthCommercialAugust 1, 2025
Upcoming updates: medical claims edit system for self‑administered drugsCommercialAugust 1, 2025
New EMR messaging alerts aim to close gaps in care for ACA patientsCommercialAugust 1, 2025
Introducing a new Applied Behavior Analysis Provider Resource GuideMedicare AdvantageJuly 25, 2025
Medical Policies and Clinical Utilization Management Guidelines updateEffective August 28, 2025
CommercialMedicare AdvantageJuly 23, 2025
Enhance care provider data accuracy with updated roster toolsCommercialJuly 22, 2025
July formulary deletionsMedicare AdvantageJuly 21, 2025
Anthem Medicare Advantage Group Retiree Quick Reference GuideCommercialMedicare AdvantageJuly 18, 2025
New mandatory fields in roster templateCommercialMedicare AdvantageJuly 1, 2025
Benefits of utilization management attestations: a guide for care providersCommercialJuly 1, 2025
Material adverse change
Precertification/prior authorization list change notification July 1, 2025CommercialMedicare AdvantageJuly 1, 2025
Join the 2025 Clinical Quality in Practice webinar seriesMedicare AdvantageJuly 1, 2025
Combat diabetes: Close the statin therapy gap for better heart healthCommercialJuly 1, 2025
Reimbursement policy update: Nurse Practitioner and Physician Assistant servicesCommercialMedicare AdvantageJuly 1, 2025
Streamlining behavioral health authorizations via Availity EssentialsCommercialJuly 1, 2025
CMS drug fee schedule update effective August 1, 2025CommercialJuly 1, 2025
Readmission review process changeCommercialJuly 1, 2025
Update: essential ICD‑10‑CM compliance for outpatient facility claimsCommercialJuly 1, 2025
Enroll with Availity to verify your provider dataCommercialMedicare AdvantageJuly 1, 2025
Seamless Provider Enrollment and Network Management through Availity Essentials optimizes the care provider experienceMedicare AdvantageJuly 1, 2025
A quick guide to understanding JW and JZ modifiersCommercialJuly 1, 2025
A quick guide to understanding JW and JZ modifiersMedicare AdvantageJuly 1, 2025
Implementation of chargemaster‑based claims edit for ER levelingCommercialJuly 1, 2025
Material adverse change
Reimbursement policy update: Bundled Services and Supplies – ProfessionalCommercialJuly 1, 2025
Material adverse change
New reimbursement policy: Code and Clinical Editing Guidelines – Professional and FacilityCommercialMedicare AdvantageJuly 1, 2025
Update: National Drug Codes (NDCs) are required for professional and outpatient claimsMedicare AdvantageJune 27, 2025
Specialty pharmacy precertification list expandedEffective November 1, 2025
Axtle, Bizengri, and Bynfezia pen
Medicare AdvantageJune 23, 2025
Essential information for providers: understanding Medicare Advantage group retiree plansMedicare AdvantageJune 17, 2025
Specialty pharmacy precertification list expansion — key updatesCommercialMedicare AdvantageJune 6, 2025
National Drug Codes (NDCs) are required for outpatient claimsCommercialJune 1, 2025
Collection of diversity and cultural competency training received in 2024CommercialJune 1, 2025
Update to claims system for global surgical procedures for professional providersMedicare AdvantageJune 1, 2025
Bridging the gap: enhancing medication adherence for better health outcomesCommercialMedicare AdvantageJune 1, 2025
Registration is now available for our upcoming CME webinar on Integrating Cancer CareMedicare AdvantageJune 1, 2025
Claims guidance: updating inpatient and outpatient bill typesCommercialJune 1, 2025
Availity Essentials Provider Overpayments application launchCommercialMedicare AdvantageJune 1, 2025
LabCorp and Quest Diagnostics are in-network — reminderCommercialJune 1, 2025
Material adverse change
Drug list updates — designated medical specialty pharmacy