June 1, 2025

June 2025 Provider Newsletter

Filter By: AllCommercialMedicare AdvantageMedicaid

Featured Articles

Education & TrainingMedicare AdvantageMay 27, 2025

Learn about annual Model of Care training for special needs plans

Education & TrainingMedicaidMay 22, 2025

Provider manual updates for Nevada Medicaid

Education & TrainingCommercialMedicare AdvantageMedicaidMay 27, 2025

Boost your roster submission skills with Availity Essentials

Education & TrainingCommercialJune 1, 2025

Availity Essentials Provider Overpayments application launch

Administrative

AdministrativeCommercialMedicare AdvantageJune 1, 2025

LabCorp and Quest Diagnostics are in-network — reminder

AdministrativeCommercialJune 1, 2025

Update to claims system for global surgical procedures for professional providers

Digital SolutionsCommercialMedicare AdvantageMedicaidMarch 1, 2025

Reminder: provider data attestation

Digital SolutionsCommercialMedicare AdvantageMedicaidJune 1, 2025

Submitting BH authorizations in Availity Essentials

Education & Training

Education & TrainingMedicaidMay 13, 2025

You are invited: Medicaid provider orientation

Education & TrainingMedicare AdvantageJune 1, 2025

Bridging the gap: enhancing medication adherence for better health outcomes

Education & TrainingMedicare AdvantageJune 1, 2025

Claims guidance: updating inpatient and outpatient bill types

WebinarsCommercialMedicare AdvantageMedicaidJune 1, 2025

Registration is now available for our upcoming CME webinar on Integrating Cancer Care

Policy Updates

Policy UpdatesMedicaidApril 25, 2025

Carelon Medical Benefits Management, Inc. updates

Effective July 26, 2025

Policy UpdatesMedicare AdvantageMay 13, 2025

Clinical Criteria updates

Effective June 20, 2025

Policy UpdatesMedicaidMay 14, 2025

Carelon Medical Benefits Management, Inc. updates

Effective June 20, 2025

Medical Policy & Clinical GuidelinesCommercialJune 1, 2025

Medical Policies and Clinical Utilization Management Guidelines are now available

Products & Programs

PharmacyCommercialJune 1, 2025

Unlock updated pharmacy insights today — visit our provider website

PharmacyMedicare AdvantageMay 22, 2025

New specialty pharmacy medical step therapy requirements

Effective July 1, 2025
Pavblu, Ahzantive, Enzeevu, Opuviz, and Yesafili

PharmacyMedicaidMay 15, 2025

Prior authorization updates for medications billed under the medical benefit

Effective July 1, 2025
Jubbonti; Wyost, Nemluvio, Nypozi, Rytelo, Tecelra, and Yimmugo

PharmacyMedicaidMay 20, 2025

Prior authorization updates for medications billed under the medical benefit

Effective July 1, 2025
Ahzantive, Enzeevu, Opuviz, Pavblu, and Yesafili

Quality Management

Quality ManagementMedicaidJune 1, 2025

Enhance patient care with our Complex Care Management program

NVBCBS-CDCRCM-083881-25-CPN83757