May 31, 2023
June 2023 Provider Newsletter
Featured Articles
CommercialMay 31, 2023
Correction: Federal Employee Program® Quality Reimbursement program update
Administrative
CommercialSeptember 1, 2023
Consider a FIT kit for your patients aged 45 and older at average risk for colon cancerCommercialMay 31, 2023
CAA: Have you reviewed your online provider directory information lately?MedicaidMay 24, 2023
Help your patients stay coveredMedicaidMay 31, 2023
Enrollment and revalidation requirements Medicaid participationMedicaidMay 31, 2023
Member Rights and Responsibilities sectionCommercialMedicare AdvantageMay 19, 2023
Anthem to implement new strategic provider system in August 2023CommercialMay 31, 2023
Digital notifications are coming June 1, 2023Education & Training
CommercialMedicaidMay 31, 2023
Building Vaccine Confidence – A webinar hosted by PfizerPolicy Updates
CommercialMay 31, 2023
MCG Care Guidelines 27th EditionCommercialMay 31, 2023
HCPCS to revenue code alignment – Evaluation/ManagementMedicare AdvantageMay 31, 2023
MCG Care Guidelines 27th EditionCommercialMay 31, 2023
Change notification to Medical Policies and Clinical UM Guidelines: (MAC)MedicaidMay 2, 2023
MCG Care Guidelines 27th editionMedicare AdvantageMay 4, 2023
Clinical Criteria Updates December 2022CommercialMay 31, 2023
Updates to Carelon Medical Benefits Management, Inc. Advanced Imaging, Sleep Disorder Management, and Spine Surgery Clinical Appropriateness Guidelines (MAC)MedicaidMay 23, 2023
Transition to Carelon Medical Benefits Management, Inc. MRI Breast Clinical Appropriateness GuidelinesMedicaidMay 18, 2023
Medical Policies and Clinical Utilization Management Guidelines updateMedicare AdvantageMay 31, 2023
Medicare Part B Precert Expansion Briumvi LeqembiMedicare AdvantageMay 31, 2023
Medicare Part B Step Therapy VegzelmaCommercialMay 31, 2023
Effective August 1, 2023, Carelon Medical Benefits Management, Inc. programs will expandCommercialMay 31, 2023
New reimbursement policy: Provider Preventable Conditions – Professional and Facility (MAC)CommercialMay 31, 2023
Reimbursement policy update: Bundled Services and Supplies — ProfessionalCommercialMay 31, 2023
Reimbursement policy update: Bundled Services and Supplies policy – Professional (MAC)Products & Programs
CommercialMay 31, 2023
Expansion of Back Pain Guide Program effective July 1, 2023CommercialMay 31, 2023
OBRA 93 claim filing for Federal Employee ProgramCommercialMay 31, 2023
BioPlus provider FAQCommercialMarch 1, 2023
Pharmacy information available on our provider websiteQuality Management
CommercialMedicare AdvantageMay 31, 2023
Patient Safety Skilled Nursing Facility (SNF) SurveyMedicare AdvantageMay 2, 2023
Colorectal Cancer Screening (COL) and Care for Older Adults (COA) for HEDISMedicare AdvantageMay 22, 2023
SPC ExclusionsMedicaidMay 31, 2023
Important information about utilization managementMedicaidMay 31, 2023
Complex Care Management programNVBCBS-CDCRCM-024896-23
* Carelon Medical Benefits Management, Inc. is an independent company providing utilization management services on behalf of the health plan. BioPlus Specialty Pharmacy is an independent company providing pharmacy services on behalf of the health plan.
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