May 1, 2025

May 2025 Provider Newsletter

Filter By: AllCommercialMedicare Advantage

Featured Articles

Administrative

AdministrativeMedicare AdvantageMay 1, 2025

Additional drug codes added to medical claims edit system

AdministrativeCommercialMay 1, 2025

Unlock the power of electronic claims with Availity Essentials

Education & Training

Education & TrainingCommercialMay 1, 2025

Streamline your prior authorizations with our digital tools

Education & TrainingCommercialMay 1, 2025

Free CE training: Lifestyle Medicine & Food as Medicine Essentials Course

Policy Updates

Policy UpdatesCommercialMay 1, 2025

Clinical Criteria updates for specialty pharmacy are available

Policy UpdatesCommercialMay 1, 2025

Medical Policy Updates for Georgia

Medical Policy & Clinical GuidelinesMedicare AdvantageApril 24, 2025

Medical Policies and Clinical Utilization Management Guidelines update

Effective May 25, 2025

Medical Policy & Clinical GuidelinesCommercialMedicare AdvantageApril 30, 2025

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

Effective August 1, 2025

Products & Programs

PharmacyMedicare AdvantageApril 18, 2025

New specialty pharmacy medical step therapy requirement

Effective June 1, 2025
Hercessi

PharmacyMedicare AdvantageApril 18, 2025

Specialty pharmacy preapproval list update

Effective August 1, 2025
Jubbonti; Wyost

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