September 1, 2023
September 2023 Provider Newsletter
Filter By: AllCommercialMedicare AdvantageMedicaid
Featured Articles
CommercialMedicaidAugust 18, 2023
Help your patients continue their care and navigate Medicaid renewal
MedicaidSeptember 1, 2023
Reminder: Start using the Provider Data Management application now on Availity Essentials — retirement of previous intake channels October 1, 2023
CommercialSeptember 1, 2023
HCPCS to revenue code alignment
Medicare AdvantageSeptember 1, 2023
Reminder: Review the health reimbursement arrangement and care plan updates in Availity Essentials
Administrative
CommercialSeptember 1, 2023
CAA: Have you reviewed your online provider directory information lately?CommercialSeptember 1, 2023
Support documentation for Carelon Medical Benefits Management, Inc. prior authorization requestsCommercialSeptember 1, 2023
Update — Enhanced outpatient facility editing for National Correct Coding InitiativeCommercialSeptember 1, 2023
Consider a FIT kit for your patients aged 45 and older at average risk for colon cancerCommercialSeptember 1, 2023
Member search feature enhancement: Search for a patient without using member ID in Availity EssentialsCommercialSeptember 1, 2023
Improvements to Digital RFAI Attachment filtering and reportingMedicare AdvantageSeptember 1, 2023
Personalized match phase 1: Specialist provider overviewCommercialSeptember 1, 2023
Simplifying claims attachments: Digital Request for Additional Information through Availity.comEducation & Training
CommercialMedicare AdvantageMedicaidJuly 7, 2023
You're invited: Thriving, not just surviving: Youth mental health in today's worldPolicy Updates
MedicaidJuly 27, 2023
MCG Care Guidelines 27th editionMedicaidJuly 28, 2023
Clinical Criteria updates - November 2022MedicaidJuly 28, 2023
Clinical Criteria updates - March 2023Medicare AdvantageAugust 14, 2023
Clinical Criteria updates - May 2023CommercialSeptember 1, 2023
Medical policies and clinical guidelines updates - September 2023CommercialSeptember 1, 2023
Medical policies and clinical guidelines moving to pre-certCommercialSeptember 1, 2023
Medical policies and clinical guidelines updatesMedicaidSeptember 1, 2023
Important information about utilization managementMedicaidAugust 14, 2023
Prior authorization requirement changes effective October 1, 2023CommercialMedicare AdvantageJune 9, 2023
Carelon Medical Benefits Management, Inc. advanced imaging — Imaging of the brain CPT code list updateMedicare AdvantageAugust 7, 2023
Prior authorization requirement changes effective December 1, 2023CommercialSeptember 1, 2023
Reimbursement policy update: Documentation Standards for Episodes of Care - ProfessionalCommercialSeptember 1, 2023
Reimbursement policy update: Documentation and Reporting Guidelines for Evaluation and Management Services - ProfessionalCommercialSeptember 1, 2023
Reimbursement policy update: Place of Service – FacilityCommercialSeptember 1, 2023
Clarification to reimbursement policy update: Prolonged Services – ProfessionalCommercialSeptember 1, 2023
New reimbursement policy: Split Care Surgical Modifiers - ProfessionalMedicaidSeptember 1, 2023
Technology Assisted Surgical ProceduresProducts & Programs
MedicaidSeptember 1, 2023
Pregnancy and maternal materials for our obstetrician care partnersCommercialSeptember 1, 2023
Specialty pharmacy updates – September 2023CommercialSeptember 1, 2023
Sublocade® updateMedicare AdvantageAugust 3, 2023
Specialty pharmacy medical step therapy for hyaluronan injectionsMedicare AdvantageJuly 28, 2023
UPDATED: Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification listQuality Management
CommercialMedicaidSeptember 1, 2023
Congenital syphilis is a sentinel health eventMedicare AdvantageSeptember 1, 2023
Medication reconciliation post inpatient dischargeMedicaidSeptember 1, 2023
Members’ Rights and Responsibilities sectionMedicaidSeptember 1, 2023
Complex Case Management programKYBCBS-CDCRCM-035541-23
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