Key Updates
CommercialMedicare AdvantageAugust 1, 2025
You are invited: immunization measures webinar
CommercialJuly 24, 2025
Specialty pharmacy updates — August 2025
CommercialMedicare AdvantageJuly 23, 2025
Enhance care provider data accuracy with updated roster tools
Recent Updates
Medicare AdvantageAugust 14, 2025
Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness GuidelinesCommercialAugust 14, 2025
Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness GuidelinesMedicare AdvantageAugust 14, 2025
Precertification/prior authorization requirement changesEffective December 1, 2025
Medicare AdvantageAugust 1, 2025
Expanded specialty pharmacy precertification listCommercialAugust 1, 2025
SUD confidentiality protections for membersCommercialAugust 1, 2025
Support your patients with the CarelonRx, Inc. and Lark Weight Management ProgramCommercialMedicare AdvantageAugust 1, 2025
You are invited: immunization measures webinarCommercialAugust 1, 2025
Facility diagnostic radiopharmaceuticals and contrast mediaCommercialMedicare AdvantageAugust 1, 2025
Compatibility in care: sharing REL data to improve member healthCommercialAugust 1, 2025
Upcoming updates: medical claims edit system for self‑administered drugsCommercialAugust 1, 2025
New EMR messaging alerts aim to close gaps in care for ACA patientsCommercialAugust 1, 2025
Attest to your practice’s data accuracy with Availity Essentials PDMCommercialAugust 1, 2025
Introducing a new Applied Behavior Analysis Provider Resource GuideCommercialAugust 1, 2025
Medical Policy and Clinical Guideline Updates - June 30, 2025CommercialAugust 1, 2025
Clinical criteria updates for specialty pharmacy now availableEffective November 1, 2025
Medicare 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 providersCommercialJuly 1, 2025
Reimbursement policy update: Bundled Services and Supplies — ProfessionalCommercialMedicare 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
A quick guide to understanding JW and JZ modifiersMedicare 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 experienceCommercialMedicare AdvantageJuly 1, 2025
Update: National Drug Codes (NDCs) are required for professional and outpatient claimsMedicare AdvantageJune 27, 2025
Specialty pharmacy precertification list expandedEffective November 1, 2025
Axtle, Bizengri, and Bynfezia pen
Medicare AdvantageJune 23, 2025
Essential information for providers: understanding Medicare Advantage group retiree plansMedicare AdvantageJune 17, 2025
Specialty pharmacy precertification list expansion — key updatesCommercialMedicare AdvantageJune 6, 2025
National Drug Codes (NDCs) are required for outpatient claimsMedicare AdvantageJune 3, 2025
Precertification/prior authorization requirement changesEffective November 1, 2025
CommercialJune 2, 2025
Specialty pharmacy updates: June 2025Medicare AdvantageJune 1, 2025
Claims guidance: updating inpatient and outpatient bill typesCommercialJune 1, 2025
Clinical Criteria updates for specialty pharmacy are now availableMedicare AdvantageJune 1, 2025
Bridging the gap: enhancing medication adherence for better health outcomesCommercialJune 1, 2025
Availity Essentials Provider Overpayments application launchCommercialMedicare AdvantageJune 1, 2025
Registration is now available for our upcoming CME webinar on Integrating Cancer Care