Key Updates
CommercialMedicare AdvantageNovember 1, 2024
Roster Automation updates: roster download functionality
CommercialMedicare AdvantageOctober 24, 2024
Time to prepare for HEDIS medical record review
CommercialOctober 23, 2024
Do you offer telehealth services? Let us know!
Recent Updates
CommercialNovember 21, 2024
Expansion of Carelon Medical Benefits Management, Inc. programsMedicare AdvantageNovember 18, 2024
New Hampshire 2025 Medicare Advantage plan changesCommercialNovember 18, 2024
Specialty pharmacy updates — December 2024Medicare AdvantageNovember 18, 2024
Expansion of Carelon Medical Benefits Management, Inc. programsMedicare AdvantageNovember 18, 2024
Notice of change: Part D Rx HCCsMedicare AdvantageNovember 15, 2024
Skilled nursing facility — vaccine serum compensationMedicare AdvantageNovember 14, 2024
Medicare Part D overhaul: What's new in 2025 for your prescription drug costs?CommercialMedicare AdvantageNovember 1, 2024
Roster Automation updates: roster download functionalityCommercialNovember 1, 2024
Introducing a new Applied Behavior Analysis Provider Resource GuideCommercialNovember 1, 2024
High Performing and Blue National Designated Providers may also be known as Anthem Diamond ProvidersCommercialNovember 1, 2024
Adopting digital member ID cardsCommercialNovember 1, 2024
New claims requirement: add-on codes must include primary procedure starting December 2024CommercialNovember 1, 2024
Precertification List Change Notification — November 1, 2024CommercialNovember 1, 2024
Submit corrected claims electronically for the Federal Employee Program®CommercialNovember 1, 2024
Precertification List Change Notification — November 1, 2024Codes J3393 and J3394
CommercialNovember 1, 2024
More error types for corrected claims submitted through EDI now availableMedicare AdvantageNovember 1, 2024
Improving patient outcomes: back to the basicsCommercialNovember 1, 2024
Provider manual update regarding Chargemaster audits effective January 1, 2025CommercialNovember 1, 2024
Personalized Match updateMedicare AdvantageMedicaidOctober 29, 2024
HEDIS Measure Tips — Appropriate Treatment for Upper Respiratory Infection (URI) 2025CommercialMedicare AdvantageOctober 24, 2024
Time to prepare for HEDIS medical record reviewCommercialOctober 24, 2024
Specialty pharmacy updates — November 2024CommercialMedicare AdvantageOctober 23, 2024
HEDIS Measure Tips — Appropriate Testing for Pharyngitis (CWP) 2025CommercialOctober 23, 2024
Do you offer telehealth services? Let us know!CommercialMedicare AdvantageOctober 22, 2024
HEDIS Measure Tips — Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB) 2025Medicare AdvantageOctober 16, 2024
Clarification to Carelon Medical Benefits Management, Inc. updates effective September 1, 2024CommercialMedicare AdvantageOctober 7, 2024
HEDIS Measure Tips — Cardiac Rehabilitation (CRE) 2025Medicare AdvantageOctober 4, 2024
HEDIS Measure Tips — Adults’ Access to Preventive/Ambulatory Health Services (AAP) 2025CommercialMedicare AdvantageOctober 3, 2024
Blood Pressure Control for Patients With Diabetes (BPD) 2025Medicare AdvantageOctober 2, 2024
Pharmacotherapy Management of COPD Exacerbation (PCE) 2025CommercialOctober 1, 2024
Introduction of the HPP designation program for individual member (Exchange) commercial networksCommercialOctober 1, 2024
National Accounts 2025 precertification listCommercialOctober 1, 2024
Introduction of the Specialty High Performing Provider designation program for commercial networksCommercialMedicare AdvantageOctober 1, 2024
Prevent flu and COVID-19: drive the change through vaccinationMedicare AdvantageOctober 1, 2024
Medicare Part D overhaul: What's new in 2025 for your prescription drug costs?CommercialMedicare AdvantageOctober 1, 2024
HEDIS medical record submission made easier with our Remote EMR Access serviceCommercialOctober 1, 2024
Clinical Criteria updates for specialty pharmacyCommercialOctober 1, 2024
Now live: view your fee schedule in Availity Essentials Payer SpacesMedicare AdvantageOctober 1, 2024
Introducing the Care Provider Recognition Program from AnthemCommercialOctober 1, 2024
Medical Policy and Clinical Guideline updatesMedicare AdvantageOctober 1, 2024
Clarification to reimbursement policy update: Nurse Practitioner and Physician Assistant ServicesCommercialOctober 1, 2024
Pharmacy information available on our provider websiteMedicare AdvantageSeptember 25, 2024
Carelon Medical Benefits Management, Inc. updatesEffective October 26, 2024
Medicare AdvantageSeptember 24, 2024
Prior authorization requirement changesEffective February 1, 2025
Medicare AdvantageSeptember 23, 2024
Prior authorization requirement changesEffective January 1, 2025
Medicare AdvantageSeptember 23, 2024
Osteoporosis Management in Women Who Had a Fracture (OMW) 2025Medicare AdvantageSeptember 19, 2024
HEDIS Measure Tips — Osteoporosis Screening in Older Women (OSW) 2025