Key Updates
CommercialMedicare AdvantageMedicaidNovember 1, 2024
Roster Automation updates: roster download functionality
CommercialMedicare AdvantageMedicaidOctober 25, 2024
Time to prepare for HEDIS medical record review
MedicaidOctober 23, 2024
Reminder: take action to protect infants from respiratory syncytial virus this season
CommercialOctober 23, 2024
Do you offer telehealth services? Let us know!
Medicare AdvantageOctober 15, 2024
Model of Care training reminder
Recent Updates
CommercialNovember 20, 2024
Notification of authorization fax number changesMedicare AdvantageNovember 18, 2024
New York 2025 Medicare Advantage plan changesMedicare AdvantageNovember 18, 2024
New York 2025 Medicare Advantage plan changesMedicare 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?MedicaidNovember 13, 2024
Assertive Community Treatment (ACT) Provider BulletinMedicaidNovember 5, 2024
Prior authorization updates for medications billed under the medical benefitCommercialMedicare AdvantageMedicaidNovember 1, 2024
Roster Automation updates: roster download functionalityCommercialNovember 1, 2024
Introducing a new Applied Behavior Analysis Provider Resource GuideCommercialNovember 1, 2024
Material adverse change
Reimbursement policy update: Nurse Practitioner and Physician Assistant ServicesMedicaidNovember 1, 2024
Enhanced personalized match: making the care provider search more informed and personalizedCommercialNovember 1, 2024
High Performing and Blue National Designated Providers may also be known as Anthem Diamond ProvidersCommercialNovember 1, 2024
Now live: view your fee schedule in Availity Essentials Payer SpacesCommercialNovember 1, 2024
New claims requirement: add-on codes must include primary procedure starting December 2024CommercialNovember 1, 2024
Personalized Match updateMedicare AdvantageNovember 1, 2024
Improving patient outcomes: back to the basicsCommercialNovember 1, 2024
Material adverse change
Precertification List Change Notification — November 1, 2024MedicaidNovember 1, 2024
After hours for primary care physiciansCommercialNovember 1, 2024
Material adverse change
Precertification List Change Notification — November 1, 2024Codes J3393 and J3394
CommercialNovember 1, 2024
More error types for corrected claims submitted through EDI now availableCommercialMedicare AdvantageMedicaidOctober 25, 2024
Time to prepare for HEDIS medical record reviewMedicaidOctober 24, 2024
Provider: CAHPS awarenessCommercialMedicare AdvantageOctober 23, 2024
HEDIS Measure Tips — Appropriate Testing for Pharyngitis (CWP) 2025MedicaidOctober 23, 2024
CPT Category II updateMedicaidOctober 23, 2024
Reminder: take action to protect infants from respiratory syncytial virus this seasonCommercialOctober 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, 2024Medicare AdvantageOctober 15, 2024
Model of Care training reminderCommercialMedicare AdvantageOctober 7, 2024
HEDIS Measure Tips — Cardiac Rehabilitation (CRE) 2025Medicare AdvantageOctober 7, 2024
Protocol for providers serving members with hearing aid coverage administered by Hearing Care SolutionsMedicare AdvantageOctober 4, 2024
HEDIS Measure Tips — Adults’ Access to Preventive/Ambulatory Health Services (AAP) 2025MedicaidOctober 3, 2024
PrEP Awareness WeekCommercialMedicare AdvantageOctober 3, 2024
Blood Pressure Control for Patients With Diabetes (BPD) 2025Medicare AdvantageOctober 2, 2024
Pharmacotherapy Management of COPD Exacerbation (PCE) 2025MedicaidOctober 2, 2024
Medical Policies and Clinical Utilization Management Guidelines updateEffective November 3, 2024
CommercialMedicare AdvantageMedicaidOctober 1, 2024
Prevent flu and COVID-19: drive the change through vaccinationCommercialOctober 1, 2024
Pharmacy information available on our provider website