October 1, 2023
October 2023 Provider Newsletter
Featured Articles
CommercialMedicare AdvantageOctober 1, 2023
Looking to earn CME credits? Check out the CME Engagement Hub!
Administrative
CommercialOctober 1, 2023
Enhanced outpatient facility editing for National Correct Coding Initiative: Medically Unlikely Edits (MUEs)CommercialOctober 1, 2023
CAA: Maintain your online provider directory informationCommercialOctober 1, 2023
National Accounts 2024 Pre-certification listCommercialMedicare AdvantageSeptember 15, 2023
Non-participating lab referralsCommercialOctober 1, 2023
Drug fee schedule updateCommercialMedicare AdvantageMedicaidOctober 1, 2023
A way to help lower-income patients pay for internet serviceCommercialMedicare AdvantageMedicaidOctober 1, 2023
PDM capability now available on Availity Essentials — retirement of previous intake channels January 1, 2024Medicare AdvantageOctober 1, 2023
Personalized Match Phase 1Medicare AdvantageOctober 1, 2023
Availity: Medicare provider-facing talking points and FAQCommercialMedicare AdvantageMedicaidOctober 1, 2023
Improvements to Secure Messaging through Claims Status and Payer SpacesEducation & Training
CommercialOctober 1, 2023
New website for cancer caregiversCommercialMedicare AdvantageSeptember 22, 2023
You're invited: Thriving, not just surviving: Youth mental health in today's worldMedicare AdvantageJune 30, 2023
Required training - Model of CarePolicy Updates
CommercialOctober 1, 2023
Medical Policies and Clinical UM Guidelines update - September 2023Medicare AdvantageSeptember 13, 2023
Clinical Criteria updates - June 2023CommercialOctober 1, 2023
Transition to Carelon Medical Benefits Management, Inc. site of care guidelinesCommercialOctober 1, 2023
Reimbursement policy update: After-Hours, Emergency, and Miscellaneous E/M Services – ProfessionalMedicaidOctober 1, 2023
Genetic Tests: Once per LifetimeMedicare AdvantageOctober 1, 2023
Genetic Tests: Once per LifetimeProducts & Programs
Medicare AdvantageSeptember 19, 2023
Medicare Part B precert expansion: Adstiladrin, Altuviiio, Idacio, Lamzede, Lunsumio, Rebyota, Signifor LAR, Syfovre, and VivimustaCommercialOctober 1, 2023
Specialty pharmacy updates — October 2023Medicare AdvantageSeptember 22, 2023
Medicare Part B precert expansion: Elfabrio, Epkinly, Qalsody, Vyjuvek, and ZynyzMedicaidSeptember 14, 2023
Notice of Material Amendment to Healthcare Contract: Prior authorization updates for medications billed under the medical benefitMedicaidSeptember 14, 2023
Quarterly pharmacy formulary changes effective November 1, 2023NVBCBS-CDCRCM-038804-23-CPN38706
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