Key Updates
MedicaidJune 23, 2025
You are invited: provider education webinars
CommercialJune 1, 2025
Availity Essentials Provider Overpayments application launch
CommercialMedicare AdvantageMedicaidMay 27, 2025
Boost your roster submission skills with Availity Essentials
Recent Updates
Medicare AdvantageJune 27, 2025
Specialty pharmacy precertification list expandedMedicare AdvantageJune 27, 2025
Specialty pharmacy precertification list expandedMedicaidJune 25, 2025
Quarterly pharmacy formulary change noticeMedicare AdvantageJune 23, 2025
Essential information for providers: understanding Medicare Advantage group retiree plansMedicaidJune 23, 2025
You are invited: provider education webinarsMedicare AdvantageJune 17, 2025
Specialty pharmacy precertification list expansion — key updatesCommercialJune 16, 2025
Annual Patient Safety Attestation: action required for complianceMedicaidJune 12, 2025
2025 Clinical Practice GuidelinesMedicaidJune 5, 2025
Healthy Blood Pressure Recheck initiative: CBPCommercialMedicare AdvantageMedicaidJune 3, 2025
National Drug Codes (NDC) are required for outpatient claimsCommercialJune 2, 2025
Specialty pharmacy updates: June 2025CommercialMedicare AdvantageJune 1, 2025
LabCorp and Quest Diagnostics are in-network — reminderCommercialJune 1, 2025
Unlock updated pharmacy insights today — visit our provider websiteCommercialJune 1, 2025
Availity Essentials Provider Overpayments application launchMedicare AdvantageJune 1, 2025
Claims guidance: updating inpatient and outpatient bill typesCommercialMedicare AdvantageMedicaidJune 1, 2025
Registration is now available for our upcoming CME webinar on Integrating Cancer CareCommercialMedicare AdvantageMedicaidJune 1, 2025
Submitting BH authorizations in Availity EssentialsMedicare AdvantageJune 1, 2025
Bridging the gap: enhancing medication adherence for better health outcomesCommercialJune 1, 2025
Update to claims system for global surgical procedures for professional providersMedicaidJune 1, 2025
Utilization management: prioritizing appropriate care and transparencyMedicaidJune 1, 2025
Learn about members’ rights and responsibilitiesMedicaidJune 1, 2025
Navigating health with confidence through the Complex Case Management ProgramMedicaidMay 27, 2025
Prior authorization updates for medications billed under the medical benefitEffective July 1, 2025
Yesintek and Ziihera
Medicare AdvantageMay 27, 2025
Learn about annual Model of Care training for special needs plansCommercialMedicare AdvantageMedicaidMay 27, 2025
Boost your roster submission skills with Availity EssentialsCommercialMay 22, 2025
Action required: annual patient safety attestationMedicare AdvantageMay 22, 2025
New specialty pharmacy medical step therapy requirementsEffective July 1, 2025
Pavblu, Ahzantive, Enzeevu, Opuviz, and Yesafili
MedicaidMay 21, 2025
Medical Policies and Clinical Utilization Management Guidelines updateEffective June 25, 2025
MedicaidMay 16, 2025
You are invited: Join us for a discussion on behavioral health screeningCommercialMay 1, 2025
Unlock the power of electronic claims with Availity EssentialsMedicaidMay 1, 2025
Enhancing your learning experience: latest updates in Provider PathwaysMedicare AdvantageMedicaidMay 1, 2025
Additional drug codes added to medical claims edit systemCommercialMay 1, 2025
Streamline your prior authorizations with our digital toolsCommercialMay 1, 2025
Free CE training: Lifestyle Medicine & Food as Medicine Essentials CourseMedicaidMay 1, 2025
CPT and HCPCS coding guidelines updateCommercialMedicare AdvantageMedicaidApril 30, 2025
Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness GuidelinesEffective August 1, 2025
Medicare AdvantageApril 24, 2025
Medical Policies and Clinical Utilization Management Guidelines updateEffective May 25, 2025
MedicaidApril 21, 2025
Prevent cavities early: integrate fluoride varnish at well-child visitsMedicare AdvantageApril 18, 2025
New specialty pharmacy medical step therapy requirementEffective June 1, 2025
Hercessi
Medicare AdvantageApril 18, 2025
Specialty pharmacy preapproval list updateEffective August 1, 2025
Jubbonti; Wyost
Medicare AdvantageApril 11, 2025
Submit preapproval requests for post‑acute care services for Medicare group retiree members to Carelon Post Acute Solutions