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

June 2024 Provider Newsletter

Featured Articles

AdministrativeHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingMay 10, 2024

CarelonRx, Inc. Mail changed to CarelonRx Pharmacy on January 1, 2024

Administrative

AdministrativeCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJune 1, 2024

Availity Essentials single claim submission response reports

AdministrativeCommercialJune 1, 2024

Change to Prior Authorization Requirements

Implant — Facility Editing update

AdministrativeCommercialJune 1, 2024

CAA: Review your online provider directory information

Digital SolutionsHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingMay 14, 2024

Coming soon — Submit behavioral health authorizations through the Authorization application on Availity

Digital SolutionsMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingMay 20, 2024

Introducing new functionality for non-medical providers

Digital SolutionsCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingMay 23, 2024

Digital RFAI Availity training

Digital SolutionsCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJune 1, 2024

Digital Request for Additional Information is now available for all lines of business

Digital SolutionsMedicare AdvantageApril 17, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs

Education & Training

Education & TrainingCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJune 1, 2024

Rotary to ground educational message

Education & TrainingCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingMay 23, 2024

You are invited: Thriving, not just surviving: navigating challenging times as a clinician

Education & TrainingHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJune 1, 2024

Hepatitis C case management program

Education & TrainingMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJune 1, 2024

June is LGBTQIA+ Pride Month

Education & TrainingCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJune 1, 2024

Introducing advanced eLearning features for MyDiversePatients.com

Education & TrainingHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJune 1, 2024

ON24 platform for provider coding education and learning

Policy Updates

Policy UpdatesHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingMay 15, 2024

Clarification about the fee schedule update

Medical Policy & Clinical GuidelinesMedicare AdvantageMay 7, 2024

Clinical Criteria updates

Effective June 10, 2024

Medical Policy & Clinical GuidelinesCommercialMay 22, 2024

Change to Prior Authorization Requirements

Medical Policies and Clinical Guidelines updates – June 2024

Medical Policy & Clinical GuidelinesCommercialApril 30, 2024

Change to Prior Authorization Requirements

MCG Care Guidelines 28th edition

Medical Policy & Clinical GuidelinesMedicare AdvantageMay 1, 2024

MCG Care Guidelines 28th edition

Medical Policy & Clinical GuidelinesCommercialMay 28, 2024

Change to Prior Authorization Requirements

Updates to Carelon Post-Acute Care Clinical Appropriateness Guidelines

Medical Policy & Clinical GuidelinesCommercialMedicare AdvantageMay 3, 2024

Change to Prior Authorization Requirements

Carelon Medical Benefits Management, Inc. genetic testing code updates

Prior AuthorizationCommercialJune 1, 2024

Change to Prior Authorization Requirements

Expansion of Carelon Medical Benefits Management, Inc. programs

Products & Programs

PharmacyMedicare AdvantageJune 1, 2024

Addressing medication adherence gaps

PharmacyCommercialJune 1, 2024

Pharmacy information available on our provider website

PharmacyMedicare AdvantageJune 1, 2024

Improving patient outcomes with statin therapy in diabetes

Quality Management

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

Member Rights and Responsibilities section

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

Important information about utilization management

Quality ManagementCommercialHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingMay 13, 2024

Take action to improve adolescent immunization rates

Quality ManagementCommercialMay 6, 2024

Enhance patient access to digital health resources

Quality ManagementCommercialHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJune 1, 2024

Tips to Improve Adolescent Immunization (IMA) Rates

Quality ManagementCommercialMedicare AdvantageApril 22, 2024

Statin Use in Persons with Cardiovascular Disease (SPC) measure exclusion criteria: HEDIS® 2024 measurement year

Quality ManagementCommercialApril 19, 2024

Improving patient health and digital literacies

INBCBS-CDCRCM-059365-24

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