CommercialMedicare AdvantageAugust 1, 2023

August 2023 Provider Newsletter

Featured Articles

Education & TrainingCommercialMedicare AdvantageAugust 1, 2023

Looking to earn CME credits? Check out the CME Engagement Hub!

AdministrativeCommercialJuly 26, 2023

Updated Provider Manual posted to Anthem.com

Administrative

AdministrativeCommercialAugust 1, 2023

Anthem Blue Cross and Blue Shield appropriate coding helps provide a comprehensive picture of patients’ health and services provided

AdministrativeCommercialMedicare AdvantageAugust 1, 2023

Clinical Laboratory Improvement Amendments

AdministrativeMedicare AdvantageJuly 18, 2023

Urinary tract infection tool kits are on the way

AdministrativeCommercialAugust 1, 2023

Compliance with federal Consolidated Appropriations Act (CAA) Gag Clause provision

AdministrativeCommercialAugust 1, 2023

CAA: Review your online provider directory information regularly

Policy Updates

Policy UpdatesMedicare AdvantageJune 29, 2023

Clinical Criteria updates - March 2023

Medical Policy & Clinical GuidelinesCommercialJuly 21, 2023

Updates to Carelon Medical Benefits Management, Inc. Joint Surgery, Small Joint Surgery, and MSK Level of Care (MAC)
Material Adverse Change (MAC)

Medical Policy & Clinical GuidelinesCommercialJuly 18, 2023

Expansion of Carelon Medical Benefits Management, Inc. cardiology programs effective October 1, 2023

Medical Policy & Clinical GuidelinesMedicare AdvantageJune 22, 2023

Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness Guidelines for joint surgery and MSK level of care

Prior AuthorizationMedicare AdvantageJuly 25, 2023

Prior authorization requirement changes effective November 1, 2023

Reimbursement PoliciesMedicare AdvantageAugust 1, 2023

Technology Assisted Surgical Procedures

Products & Programs

PharmacyCommercialAugust 1, 2023

Specialty pharmacy updates - August 2023

PharmacyCommercialAugust 1, 2023

Specialty pharmacy updates - August 2023 

PharmacyCommercialAugust 1, 2023

Clinical Criteria updates for specialty pharmacy are available

PharmacyCommercialAugust 1, 2023

Pharmacy information available on our provider website

PharmacyMedicare AdvantageAugust 1, 2023

Medication adherence: Back to the basics

PharmacyMedicare AdvantageAugust 1, 2023

Why statin therapy is important in your patients with diabetes

Quality Management

Quality ManagementMedicare AdvantageAugust 1, 2023

Healthy blood pressure recheck initiative

Quality ManagementMedicare AdvantageAugust 1, 2023

Healthy blood pressure recheck initiative

Quality ManagementCommercialMedicare AdvantageJuly 14, 2023

Pharmacotherapy Management of COPD Exacerbation (PCE) HEDIS® Measure

Quality ManagementCommercialAugust 1, 2023

Congenital syphilis is a sentinel health event

GABCBS-CRCM-030299-23

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
Availity, LLC is an independent company providing administrative support services on behalf of the health plan. Carelon Medical Benefits Management, Inc. is an independent company providing utilization management services on behalf of the health plan.