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

September 2024 Provider Newsletter

Featured Articles

AdministrativeCommercialMedicare AdvantageAugust 1, 2023

Clinical Laboratory Improvement Amendments


Administrative

AdministrativeCommercialAugust 7, 2024

Change to Prior Authorization Requirements

Enhanced claims edits system for drug quality checks

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

Save time and get better results with optimized CPT code search in Availity Essentials

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

Coming soon — digital-only authorization case status notifications

Education & Training

Education & TrainingHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingAugust 23, 2024

How are we doing?

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

Coming soon: Provider e-Learning Resource Center for Payment Integrity

Education & TrainingCommercialSeptember 1, 2024

New provider resource for family caregivers of members with cancer

Policy Updates

Medical Policy & Clinical GuidelinesHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingAugust 20, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Effective October 10, 2024

Medical Policy & Clinical GuidelinesCommercialAugust 14, 2024

Change to Prior Authorization Requirements

Medical Policies and Clinical UM Guidelines updates — September 2024

Prior AuthorizationHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingAugust 23, 2024

Hospice notification updates

Prior AuthorizationHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingAugust 16, 2024

Prior authorization requirement changes

Effective October 1, 2024
Codes: 33263, 33264, 64582, C2616, and S2095

Prior AuthorizationHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingAugust 13, 2024

Prior authorization requirement changes

Effective October 1, 2024
Codes: L5926, L5615, 33276, and 33277

Prior AuthorizationHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingJuly 31, 2024

Prior authorization requirement changes

Effective October 1, 2024
Codes: L7510 and L7520

Prior AuthorizationMedicare AdvantageJuly 31, 2024

Prior authorization requirement changes

Effective December 1, 2024

Products & Programs

Federal Employee Program (FEP)CommercialJuly 31, 2024

FEP Quality Reimbursement Program for providers

Long-Term Services & SupportsCommercialSeptember 1, 2024

The Power of the Blues: Introducing the Blue National Physician Performance Dataset

PharmacyCommercialAugust 26, 2024

Change to Prior Authorization Requirements

Specialty pharmacy updates — September 2024

PharmacyMedicare AdvantageAugust 12, 2024

Anthem expands specialty pharmacy precertification list

Code: J1599

PharmacyMedicare AdvantageAugust 27, 2024

Anthem expands specialty pharmacy precertification list

Codes: C9399, J9999 and J3590

PharmacyHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingAugust 9, 2024

New prior authorization and specialty pharmacy medical step therapy requirements

PharmacyMedicare AdvantageSeptember 1, 2024

Real-time prescription benefit

PharmacyCommercialSeptember 1, 2024

Pharmacy information available on our provider website

Quality Management

Quality ManagementCommercialMedicare AdvantageAugust 13, 2024

Announcing the new HEDIS documentation library supporting coding excellence

INBCBS-CDCRCM-065285-24

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