May 1, 2024

May 2024 Provider Newsletter

Featured Articles

Administrative

AdministrativeCommercialMedicare AdvantageMay 1, 2024

Carelon Post Acute Solutions, LLC will begin operating as Carelon Medical Benefits Management, Inc.

AdministrativeCommercialMay 1, 2024

CAA: Maintain your online provider directory information

AdministrativeCommercialMay 1, 2024

Inaccurate laterality and diagnosis combination

Digital SolutionsCommercialMedicare AdvantageMedicaidMay 1, 2024

Roster automation update

Digital SolutionsCommercialApril 23, 2024

Overview of the Preference Center on Availity Essentials

Digital SolutionsCommercialMedicare AdvantageApril 15, 2024

Coming soon — Submit behavioral health authorizations through the Authorization application on Availity

Digital SolutionsMedicare AdvantageMay 1, 2024

Personalized Match update

Education & Training

Education & TrainingCommercialApril 25, 2024

Instructions for donor claim billing

Education & TrainingCommercialMedicare AdvantageMay 1, 2024

Rotary to ground educational message

Education & TrainingMedicaidMarch 31, 2023

Ready, set, renew!

Policy Updates

Medical Policy & Clinical GuidelinesMedicaidApril 1, 2024

Clinical Criteria updates — December 2023

Reimbursement PoliciesCommercialApril 3, 2024

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

Products & Programs

Products & ProgramsMedicaidMay 1, 2024

Bringing whole person care to sickle cell disease management

Federal Employee Program (FEP)CommercialMay 1, 2024

HEDIS tips: Adult Immunization Status (AIS-E)

PharmacyCommercialApril 24, 2024

Specialty pharmacy updates — May 2024

PharmacyMedicaidApril 5, 2024

Prior authorization updates for medications billed under the medical benefit

Yuflyma

PharmacyMedicaidApril 9, 2024

Prior authorization updates for medications billed under the medical benefit

Elfabrio, Epkinly, Qalsody, Vyjuvek, and Zynyz

PharmacyMedicare AdvantageApril 8, 2024

Anthem expands specialty pharmacy precertification list

PharmacyCommercialApril 9, 2024

Acquisition of Paragon Healthcare

PharmacyCommercialMarch 1, 2024

Pharmacy information available on our provider website

Quality Management

Quality ManagementCommercialMedicaidApril 15, 2024

Cervical Cancer Screening (CCS) and Prenatal and Postpartum Care (PPC) for HEDIS

Quality ManagementCommercialMedicare AdvantageMedicaidMay 1, 2024

HEDIS 2024 documentation for Controlling High Blood Pressure (CBP) and Statin Therapy for Patients with Cardiovascular Disease (SPC)

KYBCBS-CDCRCM-056139-24

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