Key Updates
CommercialMedicare AdvantageNovember 1, 2024
Roster Automation updates: roster download functionality
CommercialMedicare AdvantageOctober 24, 2024
Time to prepare for HEDIS medical record review
CommercialOctober 23, 2024
Do you offer telehealth services? Let us know!
Medicare AdvantageOctober 15, 2024
Model of Care training reminder
Recent Updates
CommercialNovember 21, 2024
Expansion of Carelon Medical Benefits Management, Inc. programsMedicare AdvantageNovember 18, 2024
Expansion of Carelon Medical Benefits Management, Inc. programsMedicare AdvantageNovember 18, 2024
Notice of change: Part D Rx HCCsMedicare AdvantageNovember 18, 2024
Georgia 2025 Medicare Advantage plan changesMedicare AdvantageNovember 15, 2024
Skilled nursing facility — vaccine serum compensationMedicare AdvantageNovember 14, 2024
Medicare Part D overhaul: What's new in 2025 for your prescription drug costs?CommercialMedicare AdvantageNovember 1, 2024
Roster Automation updates: roster download functionalityCommercialNovember 1, 2024
Introducing a new Applied Behavior Analysis Provider Resource GuideCommercialNovember 1, 2024
2025 Individual ACA updates: Blue Value network expanding, Georgia moving to a state-based exchangeCommercialNovember 1, 2024
High Performing and Blue National Designated Providers may also be known as Anthem Diamond ProvidersCommercialNovember 1, 2024
Adopting digital member ID cardsCommercialNovember 1, 2024
New claims requirement: add-on codes must include primary procedure starting December 2024CommercialNovember 1, 2024
Material adverse change
Reimbursement policy update: Nurse Practitioner and Physician Assistant ServicesCommercialNovember 1, 2024
Material adverse change
Clinical Criteria updates for specialty pharmacy are availableCommercialNovember 1, 2024
Material adverse change
Precertification List Change Notification — November 1, 2024CommercialNovember 1, 2024
Reimbursement policy reminder: Multiple Surgery — FacilityCommercialNovember 1, 2024
Material adverse change
Precertification List Change Notification — November 1, 2024Codes J3393 and J3394
CommercialNovember 1, 2024
More error types for corrected claims submitted through EDI now availableMedicare AdvantageNovember 1, 2024
Improving patient outcomes: back to the basicsMedicare AdvantageNovember 1, 2024
Streamlined medical services for SHBP retirees — Medicare Advantage plan from AnthemCommercialNovember 1, 2024
Personalized Match updateMedicare AdvantageMedicaidOctober 29, 2024
HEDIS Measure Tips — Appropriate Treatment for Upper Respiratory Infection (URI) 2025CommercialMedicare AdvantageOctober 24, 2024
Time to prepare for HEDIS medical record reviewCommercialOctober 23, 2024
Quick reference guideCommercialMedicare AdvantageOctober 23, 2024
HEDIS Measure Tips — Appropriate Testing for Pharyngitis (CWP) 2025CommercialOctober 23, 2024
Do you offer telehealth services? Let us know!CommercialMedicare AdvantageOctober 22, 2024
HEDIS Measure Tips — Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB) 2025CommercialOctober 21, 2024
Notification of authorization fax number changesMedicare AdvantageOctober 16, 2024
Clarification to Carelon Medical Benefits Management, Inc. updates effective September 1, 2024Medicare AdvantageOctober 15, 2024
Model of Care training reminderCommercialMedicare AdvantageOctober 7, 2024
HEDIS Measure Tips — Cardiac Rehabilitation (CRE) 2025Medicare AdvantageOctober 4, 2024
HEDIS Measure Tips — Adults’ Access to Preventive/Ambulatory Health Services (AAP) 2025CommercialMedicare AdvantageOctober 3, 2024
Blood Pressure Control for Patients With Diabetes (BPD) 2025Medicare AdvantageOctober 2, 2024
Pharmacotherapy Management of COPD Exacerbation (PCE) 2025CommercialOctober 1, 2024
Material adverse change
Medical Policy and Clinical Guideline updates October 1, 2024CommercialOctober 1, 2024
Introduction of the HPP designation program for individual member (Exchange) commercial networksMedicare AdvantageOctober 1, 2024
Streamlined medical services for SHBP retirees — New Medicare Advantage plan from AnthemCommercialOctober 1, 2024
National Accounts 2025 precertification listCommercialMedicare AdvantageOctober 1, 2024
HEDIS medical record submission made easier with our Remote EMR Access serviceCommercialOctober 1, 2024
Pharmacy information available on our provider websiteMedicare AdvantageOctober 1, 2024
Clarification to reimbursement policy update: Nurse Practitioner and Physician Assistant ServicesCommercialOctober 1, 2024
Material adverse change
Provider manual update available, effective January 1, 2025Medicare AdvantageOctober 1, 2024
Introducing the Care Provider Recognition Program from AnthemCommercialOctober 1, 2024
Material adverse change
Reimbursement policy update — Modifiers 59 and XE, XP, XS, and XU: Distinct Procedural Service — ProfessionalCommercialOctober 1, 2024
Now live: view your fee schedule in Availity Essentials Payer SpacesCommercialOctober 1, 2024
Introduction of the Specialty High Performing Provider designation program for commercial networks