Key Updates
Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJuly 1, 2025
Benefits of utilization management attestations: a guide for care providers
Recent Updates
Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageJuly 18, 2025
New mandatory fields in roster templateAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJuly 1, 2025
Benefits of utilization management attestations: a guide for care providersAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2025
Notice of material change/amendment to contract
New reimbursement policy: Code and Clinical Editing Guidelines — Professional and FacilityAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2025
Notice of material change/amendment to contract
Reimbursement policy update: Bundled Services and Supplies — ProfessionalAnthem Blue Cross and Blue Shield | Medicare AdvantageJuly 1, 2025
Implementation of chargemaster‑based claims edit for ER levelingAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2025
A quick guide to understanding JW and JZ modifiersAnthem Blue Cross and Blue Shield | Medicare AdvantageJuly 1, 2025
A quick guide to understanding JW and JZ modifiersAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageJuly 1, 2025
Seamless Provider Enrollment and Network Management through Availity Essentials optimizes the care provider experienceAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2025
Enroll with Availity to verify your provider dataAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2025
Notice of material change/amendment to contract
Precertification/Prior Authorization list change notification July 1, 2025Anthem Blue Cross and Blue Shield | CommercialJuly 1, 2025
Notice of material change/amendment to contract
Medical Policy and Clinical Guideline updatesAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2025
Update: essential ICD‑10‑CM compliance for outpatient facility claimsAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJuly 1, 2025
Streamlining behavioral health authorizations via Availity EssentialsAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2025
Notice of material change/amendment to contract
Notices of material changes/amendments to contract — July 2025Anthem Blue Cross and Blue Shield | Medicare AdvantageJuly 1, 2025
Combat diabetes: Close the statin therapy gap for better heart healthAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageJuly 1, 2025
Join the 2025 Clinical Quality in Practice webinar seriesAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2025
Access our updated provider manual for July 1, 2025, changesAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageJuly 1, 2025
National Drug Codes (NDCs) are required for professional and outpatient claimsAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJune 27, 2025
Specialty pharmacy precertification list expandedEffective November 1, 2025
Axtle, Bizengri, and Bynfezia pen
Anthem Blue Cross and Blue Shield | Medicare AdvantageJune 23, 2025
Essential information for providers: understanding Medicare Advantage group retiree plansAnthem Blue Cross and Blue Shield | Medicare AdvantageJune 17, 2025
Specialty pharmacy precertification list expansion — key updatesAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageJune 6, 2025
National Drug Codes (NDCs) are required for outpatient claimsAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJune 2, 2025
Clinical Criteria updatesEffective July 6, 2025
Anthem Blue Cross and Blue Shield | CommercialJune 2, 2025
Notice of material change/amendment to contract
Specialty pharmacy updates: June 2025Anthem Blue Cross and Blue Shield | CommercialJune 1, 2025
Unlock updated pharmacy insights today — visit our provider websiteAnthem Blue Cross and Blue Shield | CommercialJune 1, 2025
Notice of material change/amendment to contract
Clinical Criteria updates for specialty pharmacyAnthem Blue Cross and Blue Shield | CommercialJune 1, 2025
Update to claims system for global surgical procedures for professional providersAnthem Blue Cross and Blue Shield | Medicare AdvantageJune 1, 2025
Bridging the gap: enhancing medication adherence for better health outcomesAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageJune 1, 2025
Registration is now available for our upcoming CME webinar on Integrating Cancer CareAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJune 1, 2025
Claims guidance: updating inpatient and outpatient bill typesAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageJune 1, 2025
LabCorp and Quest Diagnostics are in-network — reminderAnthem Blue Cross and Blue Shield | CommercialJune 1, 2025
Notice of material change/amendment to contract
Notices of material changes/amendments to contract — June 2025Anthem Blue Cross and Blue Shield | CommercialJune 1, 2025
Availity Essentials Provider Overpayments application launchAMH 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 changes effective November 1, 2025Effective November 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