Key Updates
AMH Health, LLC | Medicare AdvantageMay 27, 2025
Learn about annual Model of Care training for special needs plans
Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageMay 27, 2025
Boost your roster submission skills with Availity Essentials
Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageMarch 1, 2025
Reminder: provider data attestation
Recent Updates
AMH Health, LLC | Medicare AdvantageMay 27, 2025
Learn about annual Model of Care training for special needs plansAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageMay 27, 2025
Boost your roster submission skills with Availity EssentialsAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageMay 22, 2025
Precertification/prior authorization requirement changesEffective October 1, 2025
Anthem Blue Cross and Blue Shield | CommercialMay 22, 2025
Action required: annual patient safety attestationAnthem Blue Cross and Blue Shield | Medicare AdvantageMay 22, 2025
New specialty pharmacy medical step therapy requirementsEffective July 1, 2025
Pavblu, Ahzantive, Enzeevu, Opuviz, and Yesafili
Anthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageMay 13, 2025
Clinical Criteria updatesEffective June 20, 2025
Anthem Blue Cross and Blue Shield | CommercialMay 1, 2025
Wellness visits may increase appointment scheduling For members enrolled in an ACA planAnthem Blue Cross and Blue Shield | CommercialMay 1, 2025
Free CE training: Lifestyle Medicine & Food as Medicine Essentials CourseAnthem Blue Cross and Blue Shield | CommercialMay 1, 2025
Streamline your prior authorizations with our digital toolsAnthem Blue Cross and Blue Shield | CommercialMay 1, 2025
Notice of material change/amendment to contract
Notices of material changes/amendments to contract — May 2025Anthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageMay 1, 2025
Additional drug codes added to medical claims edit systemAnthem Blue Cross and Blue Shield | CommercialMay 1, 2025
Notice of material change/amendment to contract
Clinical Criteria updates for specialty pharmacyEffective August 1, 2025
Anthem Blue Cross and Blue Shield | CommercialMay 1, 2025
Notice of material change/amendment to contract
Medical Policy and Clinical Guideline updatesEffective August 1, 2025
Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageApril 30, 2025
Notice of material change/amendment to contract
Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness GuidelinesEffective August 1, 2025
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 | 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 | 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 | 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 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 | 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 and Explanation of Payment starting in AugustAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageMarch 1, 2025
Electronic payments starting in August 2025Anthem Blue Cross and Blue Shield | CommercialMarch 1, 2025
New reimbursement policy: Place of Service — ProfessionalAnthem 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
Changes in Postal Service Health Benefits for 2025Anthem 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
Update: Drug claims edits to focus on FDA‑approved indicationsAnthem Blue Cross and Blue Shield | CommercialMarch 1, 2025
Certain modifiers for outpatient claims will receive prepayment coding reviewAnthem 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 | 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 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 4, 2025
Expansion of Carelon Medical Benefits Management, Inc. programsAnthem 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 | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageFebruary 1, 2025
New Communication Center added to Availity EssentialsAnthem 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
Reimbursement policy update: Diagnostic Radiopharmaceuticals and Contrast Materials — Professional and FacilityAnthem Blue Cross and Blue Shield | CommercialFebruary 1, 2025
Notice of material change/amendment to contract
Notices of material changes/amendments to contract — February 2025