July 1, 2025

July 2025 Provider Newsletter

Filter By: AllCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for Aging

Featured Articles

AdministrativeCommercialJuly 1, 2025

Enroll with Availity to verify your provider data

Education & TrainingCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJune 4, 2025

Boost your roster submission skills with Availity Essentials


Administrative

AdministrativeMedicare AdvantageJuly 1, 2025

Implementation of chargemaster‑based claims edit for ER leveling

AdministrativeCommercialJuly 1, 2025

A quick guide to understanding JW and JZ modifiers

AdministrativeMedicare AdvantageJuly 1, 2025

A quick guide to understanding JW and JZ modifiers

AdministrativeCommercialMedicare AdvantageJuly 1, 2025

Provider manual update effective August 2025

Digital SolutionsCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 1, 2025

Streamlining behavioral health authorizations via Availity Essentials

Digital SolutionsMedicare AdvantageJune 17, 2025

Specialty pharmacy precertification list expansion — key updates

Education & Training

Education & TrainingHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 1, 2025

Earn CME credits: Attend our engaging webinars

Education & TrainingMedicare AdvantageJuly 1, 2025

Combat diabetes: Close the statin therapy gap for better heart health

Policy Updates

Policy UpdatesCommercialJune 13, 2025

Streamlined claim submission process update

Policy UpdatesMedicare AdvantageJune 2, 2025

Clinical Criteria updates

Effective July 6, 2025

Prior AuthorizationMedicare AdvantageJune 3, 2025

Precertification/prior authorization requirement changes

Effective November 1, 2025

Reimbursement PoliciesCommercialJuly 1, 2025

Change to Prior Authorization Requirements

New reimbursement policy: Code and Clinical Editing Guidelines — Professional and Facility

Reimbursement PoliciesCommercialJuly 1, 2025

Change to Prior Authorization Requirements

Reimbursement policy update: Bundled Services and Supplies — Professional

Products & Programs

Products & ProgramsHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 1, 2025

New incentive program — smoking cessation

PharmacyCommercialJune 2, 2025

Change to Prior Authorization Requirements

Specialty pharmacy updates: June 2025

PharmacyHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJune 3, 2025

Prior authorization updates for medications billed under the medical benefit

Effective September 1, 2025
Tevimbra

Quality Management

Quality ManagementHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 1, 2025

Simplify care with our Complex Care Management program

Quality ManagementHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 1, 2025

UM guidelines for timely service preapproval and reimbursement

INBCBS-CDCRCM-085802-25-CPN85703