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
CommercialJuly 1, 2025
Enroll with Availity to verify your provider data
CommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJune 4, 2025
Boost your roster submission skills with Availity Essentials
Administrative
Medicare AdvantageJuly 1, 2025
Implementation of chargemaster‑based claims edit for ER levelingCommercialJuly 1, 2025
A quick guide to understanding JW and JZ modifiersMedicare AdvantageJuly 1, 2025
A quick guide to understanding JW and JZ modifiersMedicare AdvantageJune 23, 2025
Essential information for providers: understanding Medicare Advantage group retiree plansCommercialMedicare AdvantageJuly 1, 2025
Provider manual update effective August 2025CommercialJuly 1, 2025
Update: essential ICD‑10‑CM compliance for outpatient facility claimsCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 1, 2025
Streamlining behavioral health authorizations via Availity EssentialsMedicare AdvantageJune 17, 2025
Specialty pharmacy precertification list expansion — key updatesEducation & Training
Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 1, 2025
Earn CME credits: Attend our engaging webinarsMedicare AdvantageJuly 1, 2025
Combat diabetes: Close the statin therapy gap for better heart healthPolicy Updates
CommercialJune 13, 2025
Streamlined claim submission process updateCommercialJune 25, 2025
Provider specialty and subspecialty designations for utilization managementMedicare AdvantageJune 3, 2025
Precertification/prior authorization requirement changesEffective November 1, 2025
CommercialJuly 1, 2025
Change to Prior Authorization Requirements
New reimbursement policy: Code and Clinical Editing Guidelines — Professional and FacilityCommercialJuly 1, 2025
Change to Prior Authorization Requirements
Reimbursement policy update: Bundled Services and Supplies — ProfessionalProducts & Programs
Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 1, 2025
New incentive program — smoking cessationCommercialMay 30, 2025
Key updates to the Designated Medical Specialty Pharmacy Drug ListCommercialJune 2, 2025
Change to Prior Authorization Requirements
Specialty pharmacy updates: June 2025Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJune 3, 2025
Prior authorization updates for medications billed under the medical benefitEffective September 1, 2025
Tevimbra
Quality Management
Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 1, 2025
Simplify care with our Complex Care Management programHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 1, 2025
UM guidelines for timely service preapproval and reimbursementINBCBS-CDCRCM-085802-25-CPN85703
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