July 1, 2025

July 2025 Provider Newsletter

Filter By: AllCommercialMedicare AdvantageMedicaid

Featured Articles

AdministrativeCommercialJuly 1, 2025

Enroll with Availity to verify your provider data

WebinarsCommercialMedicare AdvantageMedicaidJuly 1, 2025

Join the 2025 Clinical Quality in Practice webinar series


Administrative

AdministrativeMedicare AdvantageJuly 1, 2025

Implementation of chargemaster‑based claims edit for ER leveling

AdministrativeCommercialJuly 1, 2025

A quick guide to understanding JW and JZ modifiers

AdministrativeMedicare AdvantageJuly 1, 2025

A quick guide to understanding JW and JZ modifiers

AdministrativeCommercialJuly 1, 2025

CMS drug fee schedule update effective August 1, 2025

Digital SolutionsCommercialMedicare AdvantageMedicaidJuly 1, 2025

Streamlining behavioral health authorizations via Availity Essentials

Digital SolutionsMedicare AdvantageJune 17, 2025

Specialty pharmacy precertification list expansion — key updates

Education & Training

Education & TrainingMedicare AdvantageJuly 1, 2025

Combat diabetes: Close the statin therapy gap for better heart health

Policy Updates

Policy UpdatesMedicare AdvantageJune 2, 2025

Clinical Criteria updates

Effective July 6, 2025

Policy UpdatesMedicaidJune 9, 2025

Clinical Criteria updates

Effective July 11, 2025

Medical Policy & Clinical GuidelinesMedicaidJune 3, 2025

Medical Policies and Clinical Utilization Management Guidelines update

Effective July 9, 2025

Prior AuthorizationMedicaidJune 13, 2025

Prior authorization requirement changes

Effective August 1, 2025

Products & Programs

PharmacyCommercialJune 2, 2025

Specialty pharmacy updates: June 2025

Quality Management

Quality ManagementMedicaidJuly 1, 2025

Important information about utilization management

NVBCBS-CDCRCM-085814-25-CPN85703