Key Updates
CommercialJune 1, 2025
Availity Essentials Provider Overpayments application launch
Medicare AdvantageJune 1, 2025
Medicare preferred continuous glucose monitors
CommercialMedicare AdvantageJune 1, 2025
LabCorp and Quest Diagnostics are in-network — reminder
CommercialMedicare AdvantageMay 27, 2025
Boost your roster submission skills with Availity Essentials
CommercialMedicare AdvantageMarch 1, 2025
Reminder: provider data attestation
Recent Updates
CommercialMedicare AdvantageJune 1, 2025
LabCorp and Quest Diagnostics are in-network — reminderCommercialMedicare AdvantageJune 1, 2025
Electronic payments starting in mid-September 2025CommercialMedicare AdvantageJune 1, 2025
Electronic Explanation of Payment starting in mid-SeptemberCommercialJune 1, 2025
Provider manual updatesCommercialJune 1, 2025
Clinical Criteria updates for specialty pharmacyCommercialJune 1, 2025
Update to claims system for global surgical proceduresMedicare AdvantageJune 1, 2025
Bridging the gap: enhancing medication adherence for better health outcomesCommercialMedicare AdvantageJune 1, 2025
Submitting BH authorizations in Availity EssentialsCommercialMedicare AdvantageJune 1, 2025
Registration is now available for our upcoming CME webinar on Integrating Cancer CareCommercialJune 1, 2025
Availity Essentials Provider Overpayments application launchCommercialJune 1, 2025
Unlock updated pharmacy insights today — visit our provider websiteMedicare AdvantageJune 1, 2025
Medicare preferred continuous glucose monitorsMedicare AdvantageJune 1, 2025
Claims guidance: updating inpatient and outpatient bill typesMedicare AdvantageMay 27, 2025
Learn about annual Model of Care training for special needs plansCommercialMedicare AdvantageMay 27, 2025
Boost your roster submission skills with Availity EssentialsCommercialMay 22, 2025
Action required: annual patient safety attestationMedicare AdvantageMay 22, 2025
New specialty pharmacy medical step therapy requirementsEffective July 1, 2025
Pavblu, Ahzantive, Enzeevu, Opuviz, and Yesafili
CommercialMay 1, 2025
Free CE training: Lifestyle Medicine & Food as Medicine Essentials CourseCommercialMay 1, 2025
Streamline your prior authorizations with our digital toolsMedicare AdvantageMay 1, 2025
Additional drug codes added to medical claims edit systemCommercialMedicare AdvantageApril 30, 2025
Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness GuidelinesEffective August 1, 2025
Medicare AdvantageApril 24, 2025
Medical Policies and Clinical Utilization Management Guidelines updateEffective July 25, 2025
Medicare AdvantageApril 18, 2025
New specialty pharmacy medical step therapy requirementEffective June 1, 2025
Hercessi
Medicare AdvantageApril 18, 2025
Specialty pharmacy preapproval list updateEffective August 1, 2025
Jubbonti; Wyost
Medicare AdvantageApril 11, 2025
Submit preapproval requests for post‑acute care services for Medicare group retiree members to Carelon Post Acute SolutionsMedicare AdvantageApril 4, 2025
Professional provider fee schedule notificationCommercialMedicare AdvantageApril 1, 2025
Register for our next webinar: Enhancing Diabetes Management — Focus on Standardized MetricsCommercialApril 1, 2025
Clarification to reimbursement policy: Incident to Services and Billing — ProfessionalCommercialMarch 28, 2025
Streamline your workflow: Submit BH authorizations through Availity EssentialsCommercialMarch 27, 2025
Specialty pharmacy updates — April 2025Medicare AdvantageMarch 27, 2025
Outpatient preapproval update from Carelon Medical Benefits Management, Inc.Medicare AdvantageMarch 19, 2025
Medicare Part B preapproval expands with new drug additionsCommercialMedicare AdvantageMarch 19, 2025
Technical difficulties: My Diverse PatientsMedicare AdvantageMarch 11, 2025
Medical Policies and Clinical Utilization Management Guidelines updateEffective June 12, 2025
CommercialMedicare AdvantageMarch 1, 2025
Reminder: provider data attestationCommercialMarch 1, 2025
Update: Drug claims edits to focus on FDA‑approved indicationsCommercialMarch 1, 2025
Precertification list change notification March 1, 2025CommercialMarch 1, 2025
Changes in Postal Service Health Benefits for 2025Medicare AdvantageFebruary 28, 2025
Important change to your patients’ specialty prescriptionsEffective April 1, 2025
CommercialMedicare AdvantageFebruary 28, 2025
Resources to support diverse patients and communitiesCommercialMedicare AdvantageFebruary 28, 2025
Update: Availity launches enhanced provider enrollment features for improved efficiency