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

October 2024 Provider Newsletter

Featured Articles

Digital SolutionsCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingSeptember 24, 2024

Roster Automation updates effective November 15, 2024: enhanced reporting to increase data accuracy

Digital SolutionsCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingSeptember 19, 2024

Maximizing care with regular provider data attestation

Digital SolutionsMedicare AdvantageOctober 1, 2024

Introducing the Care Provider Recognition Program from Anthem

Prior AuthorizationMedicare AdvantageSeptember 6, 2024

Changes to special supplemental benefits for the chronically ill eligibility requirements


Administrative

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

Inaccurate laterality and diagnosis combination

AdministrativeCommercialOctober 1, 2024

National Accounts 2025 precertification list

Digital SolutionsMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingSeptember 25, 2024

Expansion of digital-only authorization case status notifications

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

Advancing digital efficiency by discontinuing paper remittances

Digital SolutionsCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingSeptember 4, 2024

Digital Provider Enrollment now available for additional provider types in Availity Essentials

Education & Training

Education & TrainingMedicare AdvantageSeptember 16, 2024

Seamless advance care: MyDirectives digital tool for D-SNP members

Policy Updates

Policy UpdatesMedicare AdvantageSeptember 3, 2024

Clinical Criteria updates

Effective October 4, 2024

Medical Policy & Clinical GuidelinesMedicare AdvantageSeptember 10, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Effective October 10, 2024

Prior AuthorizationMedicare AdvantageSeptember 23, 2024

Prior authorization requirement changes

Effective January 1, 2025

Reimbursement PoliciesCommercialOctober 1, 2024

Change to Prior Authorization Requirements

Reimbursement policy update: Modifiers 59 and XE, XP, XS, and XU: Distinct Procedural Service — Professional

Products & Programs

PharmacyCommercialSeptember 16, 2024

Change to Prior Authorization Requirements

Specialty pharmacy updates — October 2024

PharmacyCommercialOctober 1, 2024

Pharmacy information available on our provider website

Quality Management

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

HEDIS medical record submission made easier with our Remote EMR Access service

INBCBS-CDCRCM-067866-24

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