January 1, 2024

January 2024 Provider Newsletter

Filter By: AllCommercialMedicare AdvantageMedicaid

Featured Articles

Digital SolutionsCommercialDecember 26, 2023

Training for digital requests for additional information (Digital RFAI)

Education & TrainingCommercialJanuary 1, 2024

Important information about your Anthem patients’ specialty prescriptions

Quality ManagementCommercialNovember 20, 2023

Annual preventive care visits


Administrative

AdministrativeMedicare AdvantageJanuary 1, 2024

Inappropriate primary diagnosis

AdministrativeMedicaidJanuary 1, 2024

Inappropriate primary diagnosis

AdministrativeMedicaidDecember 19, 2023

Covering the preventive E&M when billed with sick E&M

AdministrativeCommercialJanuary 1, 2024

Using and billing air ambulance services appropriately

AdministrativeCommercialJanuary 1, 2024

CAA: Maintain your online provider directory information

Education & Training

Education & TrainingMedicaidMarch 31, 2023

Ready, set, renew!

Policy Updates

Medical Policy & Clinical GuidelinesMedicare AdvantageJanuary 1, 2024

Genetic testing code list update

Medical Policy & Clinical GuidelinesMedicaidDecember 18, 2023

Medical Policies and Clinical Utilization Management Guidelines update for May 2023

Medical Policy & Clinical GuidelinesMedicare AdvantageDecember 1, 2023

Clinical Criteria updates — August 2023

Medical Policy & Clinical GuidelinesCommercialMedicare AdvantageDecember 28, 2023

Transition to Carelon Medical Benefits Management, Inc. cardiology guidelines

Medical Policy & Clinical GuidelinesCommercialMedicare AdvantageJanuary 1, 2024

Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness Guidelines

Medical Policy & Clinical GuidelinesCommercialJanuary 1, 2024

Carelon Medical Benefits Management, Inc. genetic testing CPT® code list update

Prior AuthorizationMedicare AdvantageJanuary 10, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs effective April 1, 2024

Prior AuthorizationMedicaidNovember 28, 2023

Prior authorization update - Byooviz

Prior AuthorizationMedicaidDecember 18, 2023

Prior Authorization update - Lamzede, Lunsumio, Rebyota, etc.

Prior AuthorizationMedicaidNovember 28, 2023

Prior authorization requirement changes effective January 1, 2024

Products & Programs

DentalCommercialJanuary 1, 2024

January Dental newsletter communications

PharmacyCommercialDecember 28, 2023

Specialty pharmacy updates — January 2024

Quality Management

Quality ManagementMedicare AdvantageJanuary 1, 2024

Boost annual planned visit rates

Quality ManagementMedicaidJanuary 1, 2024

Healthy blood pressure recheck initiative

Quality ManagementMedicaidJanuary 1, 2024

HEDIS diabetes documentation

Quality ManagementCommercialMedicare AdvantageJanuary 1, 2024

HEDIS diabetes documentation

Quality ManagementMedicaidNovember 28, 2023

HEDIS 2023 Electronic Clinical Data Systems (ECDS)

KYBCBS-CDCRCM-047205-23

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