CommercialMedicare AdvantageApril 1, 2025

April 2025 Provider Newsletter

Featured Articles

PharmacyMedicare AdvantageFebruary 28, 2025

Important change to your patients’ specialty prescriptions

Effective April 1, 2025

Prior AuthorizationMedicare AdvantageMarch 6, 2025

Prior authorization requirement changes

Effective July 1, 2025

Administrative

Digital SolutionsCommercialMedicare AdvantageFebruary 28, 2025

Availity launches enhanced provider enrollment features for improved efficiency

Education & Training

Education & TrainingCommercialMedicare AdvantageFebruary 28, 2025

Resources to support diverse patients and communities

Education & TrainingCommercialMedicare AdvantageApril 1, 2025

Register for our next webinar: Enhancing Diabetes Management — Focus on Standardized Metrics

Education & TrainingCommercialMedicare AdvantageJanuary 1, 2025

Enhance billing and coding accuracy with new Payment Integrity training

Policy Updates

Policy UpdatesMedicare AdvantageFebruary 27, 2025

Clinical Criteria updates

Effective May 28, 2025

Medical Policy & Clinical GuidelinesMedicare AdvantageMarch 11, 2025

Medical Policies and Clinical Utilization Management Guidelines update

Effective June 12, 2025

Prior AuthorizationMedicare AdvantageMarch 26, 2025

Prior authorization requirement changes

Effective July 1, 2025

Prior AuthorizationMedicare AdvantageMarch 27, 2025

Outpatient preapproval update from Carelon Medical Benefits Management, Inc.

Reimbursement PoliciesCommercialApril 1, 2025

Clarification to reimbursement policy: Incident to Services and Billing — Professional

Products & Programs

PharmacyMedicare AdvantageMarch 19, 2025

Medicare Part B preapproval expands with new drug additions

PharmacyCommercialMarch 27, 2025

Specialty pharmacy updates — April 2025

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