CommercialMedicare AdvantageMedicaidNovember 1, 2024

November 2024 Provider Newsletter

Featured Articles

Quality ManagementCommercialMedicare AdvantageMedicaidOctober 25, 2024

Time to prepare for HEDIS medical record review

AdministrativeCommercialOctober 23, 2024

Do you offer telehealth services? Let us know!

Education & TrainingMedicare AdvantageOctober 15, 2024

Model of Care training reminder


Administrative

AdministrativeCommercialNovember 1, 2024

Personalized Match update

Digital SolutionsCommercialNovember 1, 2024

Adopting digital member ID cards

Behavioral Health

Behavioral HealthCommercialNovember 1, 2024

Introducing a new Applied Behavior Analysis Provider Resource Guide

Policy Updates

Policy UpdatesMedicare AdvantageSeptember 25, 2024

Carelon Medical Benefits Management, Inc. updates

Effective October 26, 2024

Policy UpdatesMedicaidOctober 3, 2024

Clinical Criteria updates

Effective November 4, 2024

Prior AuthorizationCommercialNovember 1, 2024

Material adverse change

Precertification List Change Notification — November 1, 2024

Prior AuthorizationCommercialNovember 1, 2024

Material adverse change

Precertification List Change Notification — November 1, 2024

Codes J3393 and J3394

Prior AuthorizationMedicaidOctober 10, 2024

Prior authorization requirement changes

Effective December 1, 2024

Prior AuthorizationMedicare AdvantageSeptember 24, 2024

Prior authorization requirement changes

Effective February 1, 2025

Products & Programs

PharmacyCommercialJuly 1, 2024

Material adverse change

Correction: Specialty pharmacy updates — July 2024

PharmacyCommercialOctober 24, 2024

Material adverse change

Specialty pharmacy updates — November 2024

PharmacyMedicare AdvantageNovember 1, 2024

Improving patient outcomes: back to the basics

PharmacyMedicaidOctober 8, 2024

Prior authorization updates for medications billed under the medical benefit

Effective December 1, 2024
Amtagvi, iDoseTR, and Nexobrid

PharmacyMedicaidOctober 4, 2024

Prior authorization updates for medications billed under the medical benefit

Effective December 1, 2024
Alyglo, Simlandi, and Winrevair

Quality Management

Quality ManagementMedicaidOctober 24, 2024

Provider: CAHPS awareness

NVBCBS-CDCRCM-070462-24

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).