Key Updates
Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 8, 2024
Reminder: Take action to protect infants from respiratory syncytial virus this season
CommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 7, 2024
Time to prepare for HEDIS medical record review
CommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 7, 2024
Time to prepare for HEDIS medical record review
CommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 7, 2024
Roster Automation updates: roster download functionality
CommercialOctober 23, 2024
Do you offer telehealth services? Let us know!
Medicare AdvantageOctober 15, 2024
Model of Care training reminder
Recent Updates
CommercialNovember 21, 2024
Expansion of Carelon Medical Benefits Management, Inc. programsCommercialNovember 18, 2024
Change to Prior Authorization Requirements
Specialty pharmacy updates — December 2024Medicare AdvantageNovember 18, 2024
Indiana 2025 Medicare Advantage plan changesMedicare AdvantageNovember 18, 2024
Expansion of Carelon Medical Benefits Management, Inc. programsMedicare AdvantageNovember 18, 2024
Notice of change: Part D Rx HCCsMedicare AdvantageNovember 15, 2024
Skilled nursing facility — vaccine serum compensationHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 15, 2024
Medical Policies, Clinical Utilization Management Guidelines updateEffective December 31, 2024
Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 14, 2024
Revised durable medical equipment (DME) rental listMedicare AdvantageNovember 14, 2024
Medicare Part D overhaul: What's new in 2025 for your prescription drug costs?Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 11, 2024
Home health utilization management processHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 8, 2024
Reminder: Take action to protect infants from respiratory syncytial virus this seasonHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 7, 2024
Provider: CAHPS awarenessCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 7, 2024
Time to prepare for HEDIS medical record reviewCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 7, 2024
Time to prepare for HEDIS medical record reviewCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 7, 2024
Roster Automation updates: roster download functionalityHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 5, 2024
Guideline update for Carelon Medical Benefits Management, Inc.Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 4, 2024
Clinical Utilization Management Criteria updateHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 4, 2024
Indiana PathWays for Aging claims testing periodCommercialNovember 1, 2024
Introducing a new Applied Behavior Analysis Provider Resource GuideCommercialNovember 1, 2024
Change to Prior Authorization Requirements
Reimbursement policy update: Nurse Practitioner and Physician Assistant ServicesCommercialNovember 1, 2024
High Performing and Blue National Designated Providers may also be known as Anthem Diamond ProvidersHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 1, 2024
Evaluation and management services correct codingCommercialNovember 1, 2024
Adopting digital member ID cardsCommercialNovember 1, 2024
Personalized Match updateHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 1, 2024
Reimbursement policy update: Nurse Practitioner and Physician Assistant ServicesCommercialNovember 1, 2024
New claims requirement: add-on codes must include primary procedure starting December 2024Medicare AdvantageNovember 1, 2024
Improving patient outcomes: back to the basicsCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 1, 2024
Prevent flu and COVID-19: drive the change through vaccinationCommercialNovember 1, 2024
Reimbursement policy reminder: Multiple Surgery — FacilityCommercialNovember 1, 2024
More error types for corrected claims submitted through EDI now availableCommercialNovember 1, 2024
Submit corrected claims electronically for the Federal Employee Program®Medicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingOctober 29, 2024
HEDIS Measure Tips — Appropriate Treatment for Upper Respiratory Infection (URI) 2025CommercialOctober 24, 2024
Change to Prior Authorization Requirements
Specialty pharmacy updates — November 2024CommercialMedicare AdvantageOctober 23, 2024
HEDIS Measure Tips — Appropriate Testing for Pharyngitis (CWP) 2025CommercialOctober 23, 2024
Do you offer telehealth services? Let us know!Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingOctober 22, 2024
Medical Policies and Clinical Utilization Management Guidelines updateEffective December 7, 2024
CommercialMedicare AdvantageOctober 22, 2024
HEDIS Measure Tips — Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB) 2025CommercialOctober 21, 2024
Notification of authorization fax number changesMedicare AdvantageOctober 16, 2024
Clarification to Carelon Medical Benefits Management, Inc. updates effective September 1, 2024Medicare AdvantageOctober 15, 2024
Model of Care training reminderHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingOctober 9, 2024
Drug testing covered in ASAM level 3.1 and 3.5 per diem bundlesCommercialMedicare AdvantageOctober 7, 2024
HEDIS Measure Tips — Cardiac Rehabilitation (CRE) 2025Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingOctober 4, 2024
Claims analysis of claims billed using the HL modifierMedicare AdvantageOctober 4, 2024
HEDIS Measure Tips — Adults’ Access to Preventive/Ambulatory Health Services (AAP) 2025CommercialMedicare AdvantageOctober 3, 2024
Blood Pressure Control for Patients With Diabetes (BPD) 2025Medicare AdvantageOctober 2, 2024
Pharmacotherapy Management of COPD Exacerbation (PCE) 2025Medicare AdvantageOctober 1, 2024
Medicare Part D overhaul: What's new in 2025 for your prescription drug costs?CommercialOctober 1, 2024
National Accounts 2025 precertification list