CommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJune 30, 2023

July 2023 Provider Newsletter

Featured Articles

Education & TrainingCommercialJune 30, 2023

Learn about disease management programs available to your patients

Products & ProgramsCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJune 30, 2023

Advancing health equity: Leveraging data to promote meaningful patient-provider relationships

Quality ManagementHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJune 30, 2023

Statin Therapy Exclusions for Patients With Cardiovascular HEDIS measures


Administrative

AdministrativeCommercialMedicare AdvantageJune 30, 2023

Unspecified diagnosis code of site and laterality

AdministrativeCommercialJune 30, 2023

Change to Prior Authorization Requirements

Notification of NCCI review of medically unlikely edits

AdministrativeCommercialJune 30, 2023

Maintain your online provider directory information

Digital SolutionsCommercialJune 30, 2023

Requests for Additional Information are now digital

Behavioral Health

Behavioral HealthCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJune 30, 2023

Important information regarding the recent Carelon Behavioral Health, Inc. assignment mailing

Education & Training

Education & TrainingCommercialJune 22, 2023

Newborn authorizations and baby names

Education & TrainingCommercialMedicare AdvantageJune 30, 2023

The BlueCard Provider Manual can answer your questions about the program

WebinarsMedicare AdvantageJune 30, 2023

Required training - Model of Care

Policy Updates

Medical Policy & Clinical GuidelinesMedicare AdvantageJune 26, 2023

Medical Policies and Clinical Utilization Management Guidelines update for February 2023

Medical Policy & Clinical GuidelinesCommercialJune 22, 2023

Change to Prior Authorization Requirements

Expansion of Carelon Medical Benefits Management, Inc. Cardiology program clinical appropriateness review for Pacemakers program

Prior AuthorizationMedicare AdvantageJune 6, 2023

Carelon Medical Benefits Management, Inc. genetic testing CPT code list update

Prior AuthorizationHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJune 22, 2023

Carelon Medical Benefits Management, Inc. lumbar infusion update

Prior AuthorizationHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJune 12, 2023

Cimerli Medical Prior Authorization update

Prior AuthorizationHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJune 9, 2023

Carelon genetic testing CPT code list update

Prior AuthorizationCommercialJune 30, 2023

Change to Prior Authorization Requirements

Carelon Medical Benefits Management, Inc. genetic testing CPT code list update

Reimbursement PoliciesCommercialJune 30, 2023

Change to Prior Authorization Requirements

Reimbursement policy update: Prolonged Services - Professional

Products & Programs

PharmacyMedicare AdvantageJune 26, 2023

Medicare Part B precert expansion may multiple drug alignment

Quality Management

Quality ManagementHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJune 30, 2023

Important information about utilization management

Quality ManagementHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJune 30, 2023

Member’s Rights and Responsibilities

INBCBS-CDCRCM-027103-23