CommercialMedicare AdvantageOctober 1, 2023

October 2023 Provider Newsletter

Featured Articles

WebinarsCommercialMedicare AdvantageOctober 1, 2023

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

Administrative

AdministrativeCommercialOctober 1, 2023

Enhanced outpatient facility editing for National Correct Coding Initiative: Medically Unlikely Edits (MUEs) 

AdministrativeCommercialOctober 1, 2023

National Accounts 2024 Pre-certification list

AdministrativeCommercialOctober 1, 2023

CAA: Maintain your online provider directory information

Digital SolutionsCommercialMedicare AdvantageOctober 1, 2023

A way to help lower-income patients pay for internet service

Digital SolutionsCommercialMedicare AdvantageOctober 1, 2023

Introducing Claims Status enhancements for claim inquiries

Digital SolutionsMedicare AdvantageOctober 1, 2023

Availity: Medicare provider-facing talking points and FAQ

Digital SolutionsMedicare AdvantageOctober 1, 2023

Personalized Match Phase 1

Education & Training

Education & TrainingCommercialOctober 1, 2023

New website for cancer caregivers

WebinarsMedicare AdvantageJune 30, 2023

Required training - Model of Care

WebinarsCommercialMedicare AdvantageSeptember 22, 2023

You're invited: Thriving, not just surviving: Youth mental health in today's world

Policy Updates

Policy UpdatesMedicare AdvantageSeptember 13, 2023

Clinical Criteria updates - June 2023

Medical Policy & Clinical GuidelinesCommercialOctober 1, 2023

Transition to Carelon Medical Benefits Management, Inc. site of care guidelines

Medical Policy & Clinical GuidelinesCommercialOctober 1, 2023

GA Medical Policy and Clinical Guideline Updates September 27, 2023

Prior AuthorizationCommercialOctober 1, 2023

Prior authorization requirement changes effective January 1, 2024 (MAC)

Reimbursement PoliciesCommercialOctober 1, 2023

Reimbursement policy update: After-Hours, Emergency, and Miscellaneous E/M Services – Professional

Reimbursement PoliciesMedicare AdvantageOctober 1, 2023

Genetic Tests: Once per Lifetime 

Products & Programs

Products & ProgramsCommercialOctober 1, 2023

Blue Value Individual Network HMO: New offering available for the Health Insurance Marketplace (Exchanges) January 1, 2024

Products & ProgramsCommercialOctober 1, 2023

Introducing the High Performing Provider designation

PharmacyCommercialOctober 1, 2023

Specialty pharmacy updates — October 2023

PharmacyMedicare AdvantageSeptember 19, 2023

Medicare Part B precert expansion: Adstiladrin, Altuviiio, Idacio, Lamzede, Lunsumio, Rebyota, Signifor LAR, Syfovre, and Vivimusta

PharmacyMedicare AdvantageSeptember 22, 2023

Medicare Part B precert expansion: Elfabrio, Epkinly, Qalsody, Vyjuvek, and Zynyz

GABCBS-CRCM-038798-23-CPN38706

Carelon Behavioral Health, Inc. is an independent company providing utilization management services on behalf of the health plan.