Key Updates
CommercialJuly 24, 2025
Specialty pharmacy updates — August 2025
Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 7, 2025
Best practices for managing provider referrals in the Care Central referrals dashboard
Recent Updates
Medicare AdvantageJuly 25, 2025
Medical Policies and Clinical Utilization Management Guidelines updateEffective August 28, 2025
CommercialJuly 24, 2025
Specialty pharmacy updates — August 2025CommercialJuly 23, 2025
Carelon Medical Benefits Management, Inc. rehabilitation solution updateCommercialJuly 22, 2025
July formulary deletionsMedicare AdvantageJuly 21, 2025
Anthem Medicare Advantage Group Retiree Quick Reference GuideHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 18, 2025
LTSS Provider Quality Incentive Programs overviewCommercialJuly 16, 2025
Anthem update for rehabilitation therapyHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 14, 2025
Ensure smooth claim processing by including NPIs on skilled services facility claimsHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 14, 2025
Indiana PathWays for Aging: Workforce Development resources and supportHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 8, 2025
The Provider Satisfaction Survey — Your opinion mattersHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 7, 2025
Provider Satisfaction Survey reminderHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 7, 2025
Best practices for managing provider referrals in the Care Central referrals dashboardMedicare AdvantageJuly 1, 2025
Combat diabetes: Close the statin therapy gap for better heart healthHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 1, 2025
New incentive program — smoking cessationHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 1, 2025
UM guidelines for timely service preapproval and reimbursementHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 1, 2025
Simplify care with our Complex Care Management programHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 1, 2025
Earn CME credits: Attend our engaging webinarsCommercialJuly 1, 2025
Update: essential ICD‑10‑CM compliance for outpatient facility claimsCommercialMedicare AdvantageJuly 1, 2025
Provider manual update effective August 2025CommercialJuly 1, 2025
Enroll with Availity to verify your provider dataMedicare AdvantageJuly 1, 2025
A quick guide to understanding JW and JZ modifiersCommercialJuly 1, 2025
A quick guide to understanding JW and JZ modifiersMedicare AdvantageJuly 1, 2025
Implementation of chargemaster‑based claims edit for ER levelingCommercialJuly 1, 2025
Change to Prior Authorization Requirements
Reimbursement policy update: Bundled Services and Supplies — ProfessionalCommercialJuly 1, 2025
Change to Prior Authorization Requirements
New reimbursement policy: Code and Clinical Editing Guidelines — Professional and FacilityCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJuly 1, 2025
Streamlining behavioral health authorizations via Availity EssentialsCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJune 27, 2025
National Drug Codes (NDC) Are Required for Outpatient ClaimsMedicare AdvantageJune 27, 2025
Specialty pharmacy precertification list expandedEffective November 1, 2025
Axtle, Bizengri, and Bynfezia pen
CommercialJune 25, 2025
Provider specialty and subspecialty designations for utilization managementCommercialJune 25, 2025
Change to Prior Authorization Requirements
Medical Policies and Clinical Guidelines updates — August 2025Medicare AdvantageJune 23, 2025
Essential information for providers: understanding Medicare Advantage group retiree plansMedicare AdvantageJune 17, 2025
Specialty pharmacy precertification list expansion — key updatesCommercialJune 13, 2025
Streamlined claim submission process updateCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJune 4, 2025
Boost your roster submission skills with Availity EssentialsMedicare AdvantageJune 3, 2025
Precertification/prior authorization requirement changesEffective November 1, 2025
Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJune 3, 2025
Prior authorization updates for medications billed under the medical benefitEffective September 1, 2025
Tevimbra
CommercialJune 2, 2025
Change to Prior Authorization Requirements
Specialty pharmacy updates: June 2025CommercialJune 1, 2025
Availity Essentials Provider Overpayments application launchCommercialMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJune 1, 2025
Submitting BH authorizations in Availity EssentialsMedicare AdvantageJune 1, 2025
Bridging the gap: enhancing medication adherence for better health outcomesCommercialMedicare AdvantageJune 1, 2025
Registration is now available for our upcoming CME webinar on Integrating Cancer CareCommercialJune 1, 2025
Update to claims system for global surgical procedures for professional providersMedicare AdvantageJune 1, 2025
Claims guidance: updating inpatient and outpatient bill typesMedicare AdvantageHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJune 1, 2025
Additional drug codes added to medical claims edit systemCommercialJune 1, 2025
Unlock updated pharmacy insights today — visit our provider websiteCommercialMedicare AdvantageJune 1, 2025
LabCorp and Quest Diagnostics are in-network — reminderHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJune 1, 2025
Clarifying roles in healthcare: member rights and responsibilitiesHoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for AgingJune 1, 2025
Provider Pathways: your personalized learning platform