Key Updates
Anthem Blue Cross and Blue Shield | CommercialMarch 28, 2025
Streamline your workflow: Submit BH authorizations through Availity Essentials
Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageFebruary 28, 2025
Update: Availity launches enhanced provider enrollment features for improved efficiency
Recent Updates
Anthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageApril 24, 2025
Medical Policies and Clinical Utilization Management Guidelines UpdateEffective May 25, 2025
Anthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageApril 18, 2025
New specialty pharmacy medical step therapy requirementEffective June 1, 2025
Hercessi
Anthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageApril 18, 2025
Specialty pharmacy preapproval list updateEffective August 1, 2025
Jubbonti; Wyost
Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageApril 16, 2025
Provider Training Opportunity: You are invited: strategies for enhancing cardiovascular care and managementAnthem Blue Cross and Blue Shield | Medicare AdvantageApril 11, 2025
Submit preapproval requests for post‑acute care services for Medicare group retiree members to Carelon Post Acute SolutionsAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageApril 2, 2025
HEDIS measure: Statin Use in Persons with Diabetes (SUPD) 2025Anthem Blue Cross and Blue Shield | CommercialApril 1, 2025
Notice of material change/amendment to contract
Notices of material changes/amendments to contract — April 2025Anthem Blue Cross and Blue Shield | CommercialApril 1, 2025
Notice of material change/amendment to contract
Specialty pharmacy updates — April 2025Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageApril 1, 2025
Register for our next webinar: Enhancing Diabetes Management — Focus on Standardized MetricsAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageMarch 31, 2025
Kidney Health Evaluation for Patients With Diabetes (KED) 2025Anthem Blue Cross and Blue Shield | CommercialMarch 28, 2025
Streamline your workflow: Submit BH authorizations through Availity EssentialsAnthem Blue Cross and Blue Shield | Medicare AdvantageMarch 27, 2025
Outpatient preapproval update from Carelon Medical Benefits Management, Inc.Anthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageMarch 19, 2025
Medicare Part B preapproval expands with new drug additionsAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageMarch 19, 2025
Technical difficulties: My Diverse PatientsAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageMarch 14, 2025
Glycemic Status Assessment for Patients with Diabetes (GSD) 2025Anthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageMarch 14, 2025
Controlling High Blood Pressure (CBP) 2025Anthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageMarch 11, 2025
Care for Older Adults (COA) 2025Anthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageMarch 11, 2025
Medical Policies and Clinical Utilization Management Guidelines updateEffective April 12, 2025
Anthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageMarch 6, 2025
Prior authorization requirement changesAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageMarch 1, 2025
Reminder: provider data attestationAnthem Blue Cross and Blue Shield | CommercialMarch 1, 2025
Notice of material change/amendment to contract
Notices of material changes/amendments to contract — March 2025Anthem Blue Cross and Blue Shield | CommercialMarch 1, 2025
Certain modifiers for outpatient claims will receive prepayment coding reviewAnthem Blue Cross and Blue Shield | CommercialMarch 1, 2025
Update: Drug claims edits to focus on FDA‑approved indicationsAnthem Blue Cross and Blue Shield | CommercialMarch 1, 2025
Notice of material change/amendment to contract
Precertification list change notification March 1, 2025Anthem Blue Cross and Blue Shield | CommercialMarch 1, 2025
New coding guidelines: include the anatomic modifierAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageMarch 1, 2025
Electronic payments starting in June 2025Anthem Blue Cross and Blue Shield | CommercialMarch 1, 2025
Changes in Postal Service Health Benefits for 2025Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageMarch 1, 2025
Electronic payments and Explanation of Payment starting in JuneAnthem Blue Cross and Blue Shield | CommercialMarch 1, 2025
Clarification to reimbursement policy: Incident to Services and Billing — ProfessionalAnthem Blue Cross and Blue Shield | CommercialMarch 1, 2025
New reimbursement policy: Place of Service — ProfessionalAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageFebruary 28, 2025
Resources to support diverse patients and communitiesAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageFebruary 28, 2025
Update: Availity launches enhanced provider enrollment features for improved efficiencyAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageFebruary 27, 2025
Clinical Criteria updatesEffective March 28, 2025
Anthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageFebruary 21, 2025
Advanced Illness and Frailty Exclusions 2025Anthem Blue Cross and Blue Shield | CommercialFebruary 21, 2025
Start 2025 with an easy way to earn continuing education creditsAnthem Blue Cross and Blue Shield | Medicare AdvantageFebruary 20, 2025
MCG Care Guidelines 29th editionEffective June 1, 2025
Anthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageFebruary 14, 2025
Clinical Criteria updatesEffective March 24, 2025
Anthem Blue Cross and Blue Shield | CommercialFebruary 11, 2025
Developmental screening in the first three years of lifeAnthem Blue Cross and Blue Shield | CommercialFebruary 11, 2025
Glycemic Status Assessment for Patients with Diabetes (GSD) 2025Anthem Blue Cross and Blue Shield | CommercialFebruary 11, 2025
Chlamydia Screening (CHL) 2025Anthem Blue Cross and Blue Shield | CommercialFebruary 10, 2025
Colorectal Cancer Screening (COL-E) 2025Anthem Blue Cross and Blue Shield | CommercialFebruary 4, 2025
Expansion of Carelon Medical Benefits Management, Inc. programsAnthem Blue Cross and Blue Shield | CommercialFebruary 1, 2025
Notice of material change/amendment to contract
Reimbursement policy update: Diagnostic Radiopharmaceuticals and Contrast Materials — Professional and FacilityAnthem Blue Cross and Blue Shield | CommercialFebruary 1, 2025
Avoidance of Antibiotics Treatment for Acute Bronchitis/Bronchiolitis (AAB)Anthem Blue Cross and Blue Shield | CommercialFebruary 1, 2025
Notice of material change/amendment to contract
Notices of material changes/amendments to contract — February 2025Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageFebruary 1, 2025
2025 Clinical Quality in Practice webinar seriesAnthem Blue Cross and Blue Shield | CommercialFebruary 1, 2025
Pharmacy information available on our provider websiteAnthem Blue Cross and Blue Shield | CommercialFebruary 1, 2025
Notice of material change/amendment to contract
Medical records needed for accurate payment of certain facility inpatient claimsAnthem Blue Cross and Blue Shield | CommercialFebruary 1, 2025
Notice of material change/amendment to contract
Clinical Criteria updates for specialty pharmacyEffective May 1, 2025
Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageFebruary 1, 2025
New Communication Center added to Availity Essentials