CommercialMedicare AdvantageMedicaidJanuary 1, 2024
January 2024 Provider Newsletter
Featured Articles
CommercialMedicare AdvantageMedicaidJanuary 1, 2024
Availity Essentials PDM application is now the intake channel for all provider demographic change requests, including roster uploads
CommercialDecember 26, 2023
Training for digital requests for additional information (Digital RFAI)
CommercialJanuary 1, 2024
Important information about your Anthem patients’ specialty prescriptions
MedicaidJanuary 1, 2024
Enrollment and revalidation requirements Medicaid participation
CommercialNovember 20, 2023
Annual preventive care visits
Administrative
MedicaidJanuary 1, 2024
Inappropriate primary diagnosisCommercialJanuary 1, 2024
Using and billing air ambulance services appropriatelyCommercialJanuary 1, 2024
Important Changes for Active Members of Northrop Grumman CorporationCommercialJanuary 1, 2024
CAA: Maintain your online provider directory informationMedicare AdvantageJanuary 1, 2024
Inappropriate primary diagnosisCommercialJanuary 1, 2024
Drug fee schedule updateEducation & Training
MedicaidMarch 31, 2023
Ready, set, renew!MedicaidJanuary 1, 2024
Provider Pathways — Learn all about itPolicy Updates
CommercialDecember 12, 2023
Nevada: Adopted Clinical Guidelines as of: January 1, 2024MedicaidDecember 4, 2023
Clinical Criteria updates — August 2023Medicare AdvantageDecember 1, 2023
Clinical Criteria updates — August 2023CommercialJanuary 1, 2024
Medical Policy and Clinical UM Guidelines notificationCommercialDecember 28, 2023
Transition to Carelon Medical Benefits Management, Inc. cardiology guidelinesCommercialJanuary 1, 2024
Carelon Medical Benefits Management, Inc. genetic testing CPT® code list updateCommercialJanuary 1, 2024
Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness GuidelinesMedicaidJanuary 1, 2024
Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness GuidelinesCommercialJanuary 1, 2024
Expansion of Carelon Medical Benefits Management, Inc. programs effective April 1, 2024MedicaidDecember 19, 2023
Prior authorization requirement changes effective February 1, 2024Codes 20979, A4555, A7025, E0692 and E0693
MedicaidDecember 8, 2023
Prior authorization requirement changes effective February 1, 2024Code J1411
Products & Programs
CommercialJanuary 1, 2024
January Dental newsletter communicationsCommercialDecember 28, 2023
Specialty pharmacy updates — January 2024Quality Management
Medicare AdvantageJanuary 1, 2024
Boost annual planned visit ratesCommercialMedicare AdvantageJanuary 1, 2024
HEDIS diabetes documentationNVBCBS-CDCRCM-047210-23
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