June 30, 2023

July 2023 Provider Newsletter

Featured Articles


Administrative

AdministrativeCommercialMedicare AdvantageJune 30, 2023

LabCorp non-participating lab referrals

AdministrativeCommercialJune 30, 2023

Notification of NCCI review of medically unlikely edits

AdministrativeCommercialMedicare AdvantageJune 30, 2023

Unspecified diagnosis code of site and laterality

AdministrativeMedicaidJune 30, 2023

Unspecified diagnosis code of site and laterality

AdministrativeCommercialJune 30, 2023

Drug fee schedule update

AdministrativeCommercialJune 30, 2023

Maintain your online provider directory information

Digital SolutionsCommercialMedicare AdvantageMedicaidJune 30, 2023

Introducing Roster Automation to improve turnaround times and data accuracy

Digital SolutionsCommercialMedicare AdvantageJune 15, 2023

We’re enhancing our data management system to streamline your demographic update process

Digital SolutionsCommercialJune 30, 2023

Requests for Additional Information are now digital

Education & Training

Education & TrainingCommercialJune 22, 2023

Newborn authorizations and baby names

Education & TrainingCommercialMedicare AdvantageJune 30, 2023

The BlueCard Provider Manual can answer your questions about the program

WebinarsMedicare AdvantageJune 30, 2023

Required training - Model of Care

Policy Updates

Policy UpdatesMedicaidJune 12, 2023

Clinical Criteria updates for February 2023

Policy UpdatesMedicaidJune 9, 2023

Clinical Criteria updates for December 2022

Policy UpdatesMedicare AdvantageJune 9, 2023

Clinical Criteria updates February 2023

Prior AuthorizationMedicaidJune 26, 2023

Medical Prior Authorization update Fylnetra, Rolvedon, and Stimufend

Prior AuthorizationCommercialJune 30, 2023

Authorizations for post-acute care services for Commercial members

Prior AuthorizationMedicaidMay 31, 2023

Cimerli Medical Prior Authorization update

Prior AuthorizationMedicare AdvantageJune 6, 2023

Carelon Medical Benefits Management, Inc. genetic testing CPT code list update

Prior AuthorizationMedicaidJune 30, 2023

Prior authorization update for select DME

Prior AuthorizationMedicaidJune 1, 2023

Spevigo and Xenpozyme Medical Prior Authorization update

Reimbursement PoliciesCommercialJune 30, 2023

Reimbursement policy update: Prolonged Services - Professional

Products & Programs

PharmacyMedicare AdvantageJune 26, 2023

Medicare Part B precert expansion may multiple drug alignment

NVBCBS-CDCRCM-027108-23