May 31, 2023

June 2023 Provider Newsletter

Filter By: AllCommercialMedicare AdvantageMedicaid

Featured Articles

Digital SolutionsCommercialMedicare AdvantageMedicaidMay 12, 2023

Enhanced Provider News website and email communications is now live!

Digital SolutionsCommercialMedicare AdvantageMay 31, 2023

Introducing Roster Automation to improve turnaround times and data accuracy

Federal Employee Program (FEP)CommercialMay 31, 2023

Correction: Federal Employee Program® Quality Reimbursement program update


Administrative

AdministrativeMedicaidMay 18, 2023

Correcting Medicaid member incarceration status errors

Digital SolutionsCommercialMay 31, 2023

Digital notifications are coming June 1, 2023

Education & Training

Education & TrainingCommercialMedicaidMay 31, 2023

Building Vaccine Confidence – A webinar hosted by Pfizer

Policy Updates

Policy UpdatesCommercialMay 31, 2023

HCPCS to revenue code alignment – Evaluation/Management

Policy UpdatesMedicare AdvantageMay 31, 2023

MCG Care Guidelines 27th Edition

Policy UpdatesMedicare AdvantageMay 4, 2023

Clinical Criteria Updates December 2022

Policy UpdatesMedicare AdvantageMay 11, 2023

Clinical Criteria Updates February 2023

Policy UpdatesCommercialMay 19, 2023

MCG Care Guidelines 27th Edition

Prior AuthorizationMedicare AdvantageMay 31, 2023

Medicare Part B Step Therapy Vegzelma

Prior AuthorizationMedicare AdvantageMay 31, 2023

Medicare Part B Precert Expansion Briumvi Leqembi

Prior AuthorizationMedicaidMay 22, 2023

Prior Authorization Requirement Changes Effective June 1, 2023

Products & Programs

Products & ProgramsCommercialMay 31, 2023

Expansion of Back Pain Guide Program effective July 1, 2023

Federal Employee Program (FEP)CommercialMay 31, 2023

OBRA 93 claim filing for Federal Employee Program

PharmacyCommercialMay 31, 2023

Specialty pharmacy updates – June 2023

PharmacyCommercialMay 31, 2023

BioPlus provider FAQ

PharmacyCommercialMarch 1, 2023

Pharmacy information available on our provider website

Quality Management

Quality ManagementCommercialMedicare AdvantageMay 31, 2023

Patient Safety Skilled Nursing Facility (SNF) Survey

Quality ManagementMedicaidMay 25, 2023

Moving Toward Equity in Asthma Care

Quality ManagementMedicare AdvantageMay 2, 2023

Colorectal Cancer Screening (COL) and Care for Older Adults (COA) for HEDIS

Quality ManagementMedicare AdvantageMay 22, 2023

SPC Exclusions

KYBCBS-CDCRCM-024892-23

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

* Carelon Medical Benefits Management, Inc. is an independent company providing utilization management services on behalf of the health plan. BioPlus Specialty Pharmacy is an independent company providing pharmacy services on behalf of the health plan.