Key Updates
CommercialMedicare AdvantageSeptember 1, 2025
Reminder: provider data attestation
Medicare AdvantageSeptember 1, 2025
Elevate your workflow with seamless patient chart uploads
CommercialMedicare AdvantageAugust 25, 2025
Enhance your skills with expanded billing and coding training
Recent Updates
Medicare AdvantageSeptember 5, 2025
Anthem expands specialty pharmacy precertification listCommercialMedicare AdvantageSeptember 2, 2025
Carelon Medical Benefits Management, Inc. Clinical Appropriateness GuidelinesEffective February 7, 2026
CommercialMedicare AdvantageSeptember 1, 2025
Reminder: provider data attestationCommercialSeptember 1, 2025
Specialty pharmacy updates — September 2025Medicare AdvantageSeptember 1, 2025
Medication safety: Reducing risks with thoughtful prescribing and monitoringCommercialSeptember 1, 2025
Anthem’s Clinical Criteria updates for specialty pharmacy are availableMedicare AdvantageSeptember 1, 2025
Elevate your workflow with seamless patient chart uploadsMedicare AdvantageSeptember 1, 2025
Elevate your practice efficiency with electronic prescriber toolsCommercialAugust 26, 2025
New guidelines for PET radiotracer management in UM beginning December 1, 2025CommercialAugust 26, 2025
Carelon Medical Benefits Management, Inc. Additional Outpatient Utilization Management and SurgicalCommercialMedicare AdvantageAugust 25, 2025
Enhance your skills with expanded billing and coding trainingMedicare AdvantageAugust 25, 2025
Anthem expands specialty pharmacy precertification listsEffective December 1, 2025
Avtozma, Osenvelt, Osenvelt, Stoboclo, and Xbryk
Medicare AdvantageAugust 21, 2025
Medication safety: Clinical strategies for EMR monitoring and preventionMedicare AdvantageAugust 14, 2025
Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness GuidelinesEffective November 15, 2025
CommercialAugust 14, 2025
Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness GuidelinesEffective November 15, 2025
Medicare AdvantageAugust 14, 2025
Precertification/prior authorization requirement changesEffective December 1, 2025
Medicare AdvantageAugust 1, 2025
Expanded specialty pharmacy precertification listEffective November 1, 2025
Bomyntra, Conexxence, Imaav, Jobevne, Omlyclo, Qfitlia, Vyalev, and Jobevne
CommercialAugust 1, 2025
New EMR messaging alerts aim to close gaps in care for ACA patientsCommercialAugust 1, 2025
Clinical criteria updates for specialty pharmacy now availableEffective November 1, 2025
CommercialAugust 1, 2025
Medical Policy and Clinical Guideline Updates - June 30, 2025CommercialAugust 1, 2025
Introducing a new Applied Behavior Analysis Provider Resource GuideCommercialAugust 1, 2025
Attest to your practice’s data accuracy with Availity Essentials PDMCommercialAugust 1, 2025
Upcoming updates: medical claims edit system for self‑administered drugsCommercialMedicare AdvantageAugust 1, 2025
Compatibility in care: sharing REL data to improve member healthCommercialAugust 1, 2025
Facility diagnostic radiopharmaceuticals and contrast mediaCommercialMedicare AdvantageAugust 1, 2025
You are invited: immunization measures webinarCommercialAugust 1, 2025
Support your patients with the CarelonRx, Inc. and Lark Weight Management ProgramCommercialAugust 1, 2025
SUD confidentiality protections for membersMedicare AdvantageJuly 25, 2025
Medical Policies and Clinical Utilization Management Guidelines updateEffective August 28, 2025
CommercialJuly 24, 2025
Specialty pharmacy updates — August 2025CommercialMedicare AdvantageJuly 23, 2025
Enhance care provider data accuracy with updated roster toolsCommercialJuly 22, 2025
July formulary deletionsMedicare AdvantageJuly 21, 2025
Anthem Medicare Advantage Group Retiree Quick Reference GuideCommercialMedicare AdvantageJuly 18, 2025
New mandatory fields in roster templateCommercialMedicare AdvantageJuly 1, 2025
Benefits of utilization management attestations: a guide for care providersCommercialMedicare AdvantageJuly 1, 2025
Join the 2025 Clinical Quality in Practice webinar seriesMedicare AdvantageJuly 1, 2025
Combat diabetes: Close the statin therapy gap for better heart healthCommercialMedicare AdvantageJuly 1, 2025
Streamlining behavioral health authorizations via Availity EssentialsCommercialJuly 1, 2025
Opportunity for providers: Establish your own facility in GeorgiaCommercialJuly 1, 2025
Update: essential ICD‑10‑CM compliance for outpatient facility claimsCommercialJuly 1, 2025
GA Precertification/Prior Authorization list change notification July 1, 2025CommercialJuly 1, 2025
Enroll with Availity to verify your provider dataMedicare AdvantageJuly 1, 2025
A quick guide to understanding JW and JZ modifiersCommercialJuly 1, 2025
Reimbursement policy update: Bundled Services and Supplies — ProfessionalMedicare AdvantageJuly 1, 2025
Implementation of chargemaster‑based claims edit for ER levelingCommercialMedicare AdvantageJuly 1, 2025
Seamless Provider Enrollment and Network Management through Availity Essentials optimizes the care provider experienceCommercialJuly 1, 2025
A quick guide to understanding JW and JZ modifiers