CommercialMedicare AdvantageMedicaidOctober 1, 2024
October 2024 Provider Newsletter
Featured Articles
Medicare AdvantageOctober 1, 2024
Introducing the Care Provider Recognition Program from Anthem
CommercialMedicare AdvantageMedicaidSeptember 12, 2024
Roster Automation updates effective November 15, 2024: enhanced reporting to increase data accuracy
Medicare AdvantageSeptember 6, 2024
Changes to special supplemental benefits for the chronically ill eligibility requirements
CommercialOctober 1, 2024
Name change — Pathway PPO to Blue Priority PPO
Administrative
CommercialOctober 1, 2024
Provider manual update available effective January 1, 2025CommercialOctober 1, 2024
National Accounts 2025 precertification listCommercialOctober 1, 2024
Drug fee schedule updateMedicare AdvantageMedicaidSeptember 18, 2024
Expansion of digital-only authorization case status notificationsMedicare AdvantageMedicaidSeptember 20, 2024
Coming soon — digital-only authorization case status notificationsCommercialMedicare AdvantageMedicaidSeptember 4, 2024
Digital Provider Enrollment now available for additional provider types in Availity EssentialsEducation & Training
Medicare AdvantageSeptember 16, 2024
Seamless advance care: MyDirectives digital tool for D-SNP membersPolicy Updates
Medicare AdvantageSeptember 10, 2024
Medical Policies and Clinical Utilization Management Guidelines updateEffective October 10, 2024
MedicaidSeptember 19, 2024
Prior authorization requirement changesEffective November 1, 2024
Code: C9790
MedicaidSeptember 19, 2024
Prior authorization requirement changesEffective November 1, 2024
Codes: 31242, 31243, 33276, 33277, 61889, 61891, 64596, 64597, J1412, J1413, L5615, and L5926
Medicare AdvantageSeptember 23, 2024
Prior authorization requirement changesEffective January 1, 2025
CommercialOctober 1, 2024
Material adverse change
Reimbursement policy update: Modifiers 59 and XE, XP, XS, and XU: Distinct Procedural Service — ProfessionalMedicare AdvantageOctober 1, 2024
Clarification to reimbursement policy update: Nurse Practitioner and Physician Assistant ServicesProducts & Programs
CommercialOctober 1, 2024
Introduction of the Specialty High Performing Provider designation program for commercial networksCommercialOctober 1, 2024
Introduction of the HPP designation program for individual member (Exchange) commercial networksMedicare AdvantageOctober 1, 2024
Medicare Part D overhaul: What's new in 2025 for your prescription drug costs?CommercialOctober 1, 2024
Pharmacy information available on our provider websiteQuality Management
CommercialMedicare AdvantageMedicaidOctober 1, 2024
Prevent flu and COVID-19: drive the change through vaccinationCommercialMedicare AdvantageMedicaidOctober 1, 2024
HEDIS medical record submission made easier with our Remote EMR Access serviceNVBCBS-CDCRCM-067879-24
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