CommercialMedicare AdvantageMedicaidMarch 1, 2024

March 2024 Provider Newsletter

Administrative

AdministrativeMedicare AdvantageMarch 1, 2024

CAA: Maintain your online provider directory information

AdministrativeMedicaidMarch 1, 2024

Clinical Laboratory Improvement Amendments

Digital SolutionsMedicare AdvantageFebruary 29, 2024

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

Digital SolutionsCommercialMarch 1, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs

Digital SolutionsCommercialFebruary 21, 2024

Beginning February 2024, you can submit Physical Health prior authorizations through the Authorization application on Availity.com

Education & Training

Education & TrainingCommercialMedicaidMarch 1, 2024

Congenital syphilis intervention opportunities for neonatal and pediatric providers

Policy Updates

Policy UpdatesMedicaidFebruary 15, 2024

MCG Care Guidelines 28th edition

Policy UpdatesMedicaidFebruary 13, 2024

Clinical Criteria updates — September 2023

Medical Policy & Clinical GuidelinesMedicare AdvantageFebruary 20, 2024

Clinical Criteria updates — December 2023

Medical Policy & Clinical GuidelinesMedicare AdvantageMarch 1, 2024

Carelon Medical Benefits Management, Inc. genetic testing code updates

Prior AuthorizationMedicaidJanuary 30, 2024

Cimerli medical prior authorization update

Prior AuthorizationMedicare AdvantageJanuary 24, 2024

Prior authorization requirement changes effective May 1, 2024

Code C1825

Prior AuthorizationMedicare AdvantageFebruary 1, 2024

Prior authorization requirement changes effective May 1, 2024

Codes G0481 - G0483

Reimbursement PoliciesCommercialMarch 1, 2024

Reimbursement policy update: Ambulance Transportation – Professional

Reimbursement PoliciesCommercialMarch 1, 2024

Reimbursement policy update: Laboratory and Venipuncture Services – Professional and Facility

Products & Programs

PharmacyCommercialFebruary 22, 2024

Specialty pharmacy updates — March 2024

PharmacyCommercialMarch 1, 2024

Important information about your Anthem patients’ Botox prescriptions

PharmacyCommercialMarch 1, 2024

Pharmacy information available on our provider website

PharmacyCommercialFebruary 20, 2024

Prior authorization updates for therapeutic duplication of specialty drugs

PharmacyMedicare AdvantageFebruary 16, 2024

Anthem expands specialty pharmacy precertification list

PharmacyMedicare AdvantageMarch 1, 2024

Overview of Medicare risk adjustment in-office prospective programs

PharmacyMedicare AdvantageJanuary 31, 2024

Notification of specialty pharmacy medical step therapy updates

Quality Management

Quality ManagementCommercialMedicaidMarch 1, 2024

Encourage Cervical Cancer Screening (CCS)

Quality ManagementMedicaidFebruary 19, 2024

HEDIS measurement year 2023 documentation for Childhood Immunization Status (CIS), Immunizations for Adolescents (IMA), and Lead Screening in Children (LSC)

Quality ManagementMedicare AdvantageFebruary 7, 2024

HEDIS® 2024 documentation for Care of Older Adults (COA)

Quality ManagementCommercialMarch 1, 2024

Boost annual preventive care visits: Tips and resources: An ounce of prevention is worth a pound of cure

KYBCBS-CDCRCM-051139-24

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