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

November 2024 Provider Newsletter

Featured Articles

AdministrativeCommercialOctober 23, 2024

Do you offer telehealth services? Let us know!

Digital SolutionsCommercialOctober 21, 2024

Notification of authorization fax number changes

Education & TrainingMedicare AdvantageOctober 15, 2024

Model of Care training reminder


Administrative

AdministrativeHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 1, 2024

Evaluation and management services correct coding

AdministrativeCommercialNovember 1, 2024

Personalized Match update

Digital SolutionsCommercialNovember 1, 2024

Adopting digital member ID cards

Behavioral Health

Behavioral HealthCommercialNovember 1, 2024

Introducing a new Applied Behavior Analysis Provider Resource Guide

Behavioral HealthHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingOctober 9, 2024

Drug testing covered in ASAM level 3.1 and 3.5 per diem bundles

Behavioral HealthHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingOctober 4, 2024

Claims analysis of claims billed using the HL modifier

Policy Updates

Policy UpdatesMedicare AdvantageSeptember 25, 2024

Carelon Medical Benefits Management, Inc. updates

Effective October 26, 2024

Medical Policy & Clinical GuidelinesHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingOctober 22, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Effective December 7, 2024

Prior AuthorizationMedicare AdvantageSeptember 24, 2024

Prior authorization requirement changes

Effective February 1, 2025

Reimbursement PoliciesCommercialNovember 1, 2024

Reimbursement policy reminder: Multiple Surgery — Facility

Reimbursement PoliciesCommercialNovember 1, 2024

Change to Prior Authorization Requirements

Reimbursement policy update: Nurse Practitioner and Physician Assistant Services

Reimbursement PoliciesHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 1, 2024

Reimbursement policy update: Nurse Practitioner and Physician Assistant Services

Products & Programs

Federal Employee Program (FEP)CommercialNovember 1, 2024

Submit corrected claims electronically for the Federal Employee Program®

PharmacyCommercialJuly 1, 2024

Change to Prior Authorization Requirements

Correction: Specialty pharmacy updates — July 2024

PharmacyCommercialOctober 24, 2024

Change to Prior Authorization Requirements

Specialty pharmacy updates — November 2024

PharmacyMedicare AdvantageNovember 1, 2024

Improving patient outcomes: back to the basics

Quality Management

Optimizing HEDIS & STARSCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingNovember 1, 2024

Prevent flu and COVID-19: drive the change through vaccination

INBCBS-CDCRCM-070451-24