June 30, 2023

July 2023 Provider Newsletter

Filter By: AllCommercialMedicare Advantage

Featured Articles

Products & ProgramsCommercialMedicare AdvantageJune 30, 2023

Advancing health equity: Leveraging data to promote meaningful patient-provider relationships

Administrative

AdministrativeCommercialJune 30, 2023

Notification of NCCI review of medically unlikely edits

AdministrativeCommercialMedicare AdvantageJune 30, 2023

Unspecified diagnosis code of site and laterality

AdministrativeCommercialJune 30, 2023

Maintain your online provider directory information

Digital SolutionsCommercialMedicare AdvantageJune 30, 2023

Provider data management capability now available on Availity Essentials — retirement of previous intake channels October 1, 2023

Digital SolutionsCommercialJune 30, 2023

Requests for Additional Information are now digital

Education & Training

Education & TrainingCommercialJune 22, 2023

Newborn authorizations and baby names

Education & TrainingCommercialMedicare AdvantageJune 30, 2023

The BlueCard Provider Manual can answer your questions about the program

WebinarsMedicare AdvantageJune 30, 2023

Required training - Model of Care

Policy Updates

Medical Policy & Clinical GuidelinesMedicare AdvantageJune 26, 2023

Medical Policies and Clinical Utilization Management Guidelines update for February 2023

Medical Policy & Clinical GuidelinesCommercialJune 22, 2023

Expansion of Carelon Medical Benefits Management, Inc. Cardiology program clinical appropriateness review for Pacemakers program

Medical Policy & Clinical GuidelinesCommercialJune 30, 2023

Medical Policy and Clinical Utilization Management Guidelines updates

Prior AuthorizationCommercialJune 30, 2023

Authorizations for post-acute care services for Commercial members

Prior AuthorizationMedicare AdvantageJune 6, 2023

Carelon Medical Benefits Management, Inc. genetic testing CPT code list update

Prior AuthorizationCommercialJune 30, 2023

Carelon Medical Benefits Management, Inc. genetic testing CPT code list update

Reimbursement PoliciesCommercialJune 30, 2023

New reimbursement policy: Multiple Procedure Payment Reduction — Professional

Reimbursement PoliciesCommercialJune 30, 2023

Reimbursement policy update: Prolonged Services - Professional

Products & Programs

PharmacyMedicare AdvantageJune 26, 2023

Medicare Part B precert expansion may multiple drug alignment

PharmacyCommercialJune 30, 2023

Clinical Criteria updates for specialty pharmacy

NHBCBS-CRCM-027107-23