CommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingSeptember 1, 2023
September 2023 Provider Newsletter
Featured Articles
Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingAugust 23, 2023
Look what’s new in Provider Pathways
Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingSeptember 1, 2023
Reminder: Start using the Provider Data Management application now on Availity Essentials — retirement of previous intake channels October 1, 2023
CommercialSeptember 1, 2023
HCPCS to revenue code alignment
Medicare AdvantageSeptember 1, 2023
Reminder: Review the health reimbursement arrangement and care plan updates in Availity Essentials
Administrative
CommercialSeptember 1, 2023
CAA: Have you reviewed your online provider directory information lately?CommercialSeptember 1, 2023
Support documentation for Carelon Medical Benefits Management, Inc. prior authorization requestsCommercialSeptember 1, 2023
Update — Enhanced outpatient facility editing for National Correct Coding InitiativeCommercialSeptember 1, 2023
Consider a FIT kit for your patients aged 45 and older at average risk for colon cancerCommercialSeptember 1, 2023
Improvements to Digital RFAI Attachment filtering and reportingMedicare AdvantageSeptember 1, 2023
Personalized match phase 1: Specialist provider overviewCommercialSeptember 1, 2023
Simplifying claims attachments: Digital Request for Additional Information through Availity.comHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingSeptember 1, 2023
Provider data management capability now available on Availity Essentials — retirement of previous intake channels October 1, 2023Education & Training
Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingAugust 24, 2023
How are we doing?CommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJuly 7, 2023
You're invited: Thriving, not just surviving: Youth mental health in today's worldPolicy Updates
Medicare AdvantageAugust 14, 2023
Clinical Criteria updates - May 2023CommercialSeptember 1, 2023
Change to Prior Authorization Requirements
Medical policies and clinical guidelines moving to pre-certCommercialSeptember 1, 2023
Change to Prior Authorization Requirements
Medical policies and clinical guidelines updates - September 2023CommercialSeptember 1, 2023
Change to Prior Authorization Requirements
Medical policies and clinical guidelines updatesCommercialMedicare AdvantageJune 9, 2023
Change to Prior Authorization Requirements
Carelon Medical Benefits Management, Inc. advanced imaging — Imaging of the brain CPT code list updateHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingAugust 23, 2023
Prior Authorization Requirement Changes Effective November 1, 2023Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingAugust 15, 2023
Durable medical equipment prior authorization updateHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingSeptember 1, 2023
Prior Authorization RequestsMedicare AdvantageAugust 7, 2023
Prior authorization requirement changes effective December 1, 2023CommercialSeptember 1, 2023
Reimbursement policy update: Documentation Standards for Episodes of Care — ProfessionalCommercialSeptember 1, 2023
Clarification to reimbursement policy update: Prolonged Services – ProfessionalCommercialSeptember 1, 2023
Reimbursement policy update: Documentation and Reporting Guidelines for Evaluation and Management Services - ProfessionalCommercialSeptember 1, 2023
Reimbursement policy update: Place of Service – FacilityCommercialSeptember 1, 2023
New reimbursement policy: Split Care Surgical Modifiers — ProfessionalProducts & Programs
CommercialSeptember 1, 2023
Change to Prior Authorization Requirements
Specialty pharmacy updates – September 2023*CommercialSeptember 1, 2023
Sublocade® updateMedicare AdvantageAugust 3, 2023
Specialty pharmacy medical step therapy for hyaluronan injectionsMedicare AdvantageJuly 28, 2023
UPDATED: Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification listQuality Management
CommercialHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingAugust 9, 2023
Moving Toward Equity in Asthma CareCommercialHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingSeptember 1, 2023
Congenital syphilis is a sentinel health eventMedicare AdvantageSeptember 1, 2023
Medication reconciliation post inpatient dischargeCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingAugust 1, 2023
Pharmacotherapy Management of COPD Exacerbation HEDIS measureINBCBS-CDCRCM-035540-23
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