CommercialMedicare AdvantageJuly 1, 2024

July 2024 Provider Newsletter

Featured Articles

Administrative

AdministrativeCommercialJuly 1, 2024

Recovery room — facility editing update

AdministrativeCommercialJuly 1, 2024

Timely receipt of other carrier EOB or rejection helps avoid timely filing denials

AdministrativeCommercialMedicare AdvantageJune 18, 2024

Phoenix Sepsis Criteria for coding and billing pediatric sepsis

AdministrativeCommercialJuly 1, 2024

CAA: Maintain your online provider directory information

Digital SolutionsCommercialJuly 1, 2024

Adopting digital member ID cards

Digital SolutionsCommercialJune 20, 2024

Digital-only authorization case status notification coming to you

Education & Training

Education & TrainingCommercialMedicare AdvantageJuly 1, 2024

July is Disability Awareness Month

Education & TrainingCommercialJune 13, 2024

Faster notification of EDI corrected claims errors

Education & TrainingCommercialMarch 12, 2024

Important reminder: The correct original claim number must be included if submitting a corrected claim

Policy Updates

Policy UpdatesMedicare AdvantageJune 4, 2024

Clinical Criteria updates

Effective July 6, 2024

Policy UpdatesMedicare AdvantageJune 3, 2024

Clinical Criteria updates — November 2023

Policy UpdatesMedicare AdvantageMay 29, 2024

Carelon Medical Benefits Management, Inc. updates

Medical Policy & Clinical GuidelinesCommercialMedicare AdvantageJune 27, 2024

Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness Guidelines

Medical Policy & Clinical GuidelinesCommercialJuly 1, 2024

Coding update effective October 1, 2024

Medical Policy & Clinical GuidelinesCommercialJuly 1, 2024

Medical Policy and Clinical Guideline updates June 28, 2024

Medical Policy & Clinical GuidelinesMedicare AdvantageMay 30, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Effective July 1, 2024

Prior AuthorizationCommercialJune 19, 2024

Carelon Medical Benefits Management, Inc. genetic testing code updates

Prior AuthorizationCommercialJuly 1, 2024

Precertification list change notification

Prior AuthorizationCommercialJuly 1, 2024

Precertification list change notification July 1, 2024

Reimbursement PoliciesCommercialJuly 1, 2024

New reimbursement policy: Diagnostic Radiopharmaceuticals and Contrast Materials — Professional and Facility

Reimbursement PoliciesCommercialJuly 1, 2024

Reimbursement policy update: Frequency Editing — Professional

Reimbursement PoliciesCommercialJuly 1, 2024

Reimbursement policy update: Incident to Services — Professional

Products & Programs

Federal Employee Program (FEP)CommercialJuly 1, 2024

Antidepressant Medication Management (AMM)

PharmacyCommercialJuly 1, 2024

Correction: Specialty pharmacy updates — July 2024

PharmacyMedicare AdvantageJune 20, 2024

Anthem expands specialty pharmacy precertification list

Quality Management

Quality ManagementMedicare AdvantageJuly 1, 2024

Understanding your role in the Health Outcomes Survey

GABCBS-CRCM-061271-24