CommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJuly 1, 2024

July 2024 Provider Newsletter

Administrative

AdministrativeCommercialJuly 1, 2024

Anesthesia modifiers — professional editing update

AdministrativeCommercialJuly 1, 2024

Recovery room — facility editing update

AdministrativeCommercialJuly 1, 2024

CAA: Maintain your online provider directory information

Digital SolutionsCommercialJune 20, 2024

Digital-only authorization case status notification coming to you

Education & Training

Education & TrainingCommercialMedicare AdvantageJuly 1, 2024

July is Disability Awareness Month

Education & TrainingCommercialJune 13, 2024

Faster notification of EDI corrected claims errors

Policy Updates

Policy UpdatesMedicare AdvantageJune 4, 2024

Clinical Criteria updates

Effective July 6, 2024

Policy UpdatesMedicare AdvantageJune 3, 2024

Clinical Criteria updates — November 2023

Policy UpdatesMedicare AdvantageMay 29, 2024

Carelon Medical Benefits Management, Inc. updates

Medical Policy & Clinical GuidelinesCommercialMedicare AdvantageJune 27, 2024

Change to Prior Authorization Requirements

Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness Guidelines

Medical Policy & Clinical GuidelinesCommercialJune 11, 2024

Change to Prior Authorization Requirements

Medical Policies and Clinical Guidelines updates for July 2024

Medical Policy & Clinical GuidelinesMedicare AdvantageMay 30, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Effective July 1, 2024

Prior AuthorizationCommercialJune 19, 2024

Change to Prior Authorization Requirements

Carelon Medical Benefits Management, Inc. genetic testing code updates

Reimbursement PoliciesCommercialJuly 1, 2024

Change to Prior Authorization Requirements

Reimbursement policy update: Incident to Services — Professional

Reimbursement PoliciesCommercialJuly 1, 2024

Change to Prior Authorization Requirements

Reimbursement policy update: Frequency Editing — Professional

Reimbursement PoliciesCommercialJuly 1, 2024

Change to Prior Authorization Requirements

New reimbursement policy: Diagnostic Radiopharmaceuticals and Contrast Materials — Professional and Facility

Products & Programs

Federal Employee Program (FEP)CommercialJuly 1, 2024

Antidepressant Medication Management (AMM)

PharmacyCommercialJuly 1, 2024

Change to Prior Authorization Requirements

Correction: Specialty pharmacy updates — July 2024

PharmacyMedicare AdvantageJune 20, 2024

Anthem expands specialty pharmacy precertification list

PharmacyCommercialJune 3, 2024

New GLP-1 prescription referral policy

Quality Management

Quality ManagementHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJuly 1, 2024

Complex Case Management program

Quality ManagementCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJuly 1, 2024

New resources to improve your HEDIS® and CAHPS® quality rates

Quality ManagementMedicare AdvantageJuly 1, 2024

Understanding your role in the Health Outcomes Survey

INBCBS-CDCRCM-061273-24

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).