CommercialMedicare AdvantageMedicaidApril 1, 2024

April 2024 Provider Newsletter

Featured Articles

Education & TrainingCommercialApril 1, 2024

Blue High Performance Network

Administrative

AdministrativeCommercialApril 1, 2024

Review your online provider directory information

AdministrativeCommercialApril 1, 2024

HCPCS to revenue code alignment for behavioral health

Digital SolutionsCommercialMarch 22, 2024

Coming soon — digital-only authorization case status notifications

Education & Training

Education & TrainingCommercialMedicare AdvantageMedicaidApril 1, 2024

April is National Minority Health Month and Stress Awareness Month

Education & TrainingCommercialMarch 12, 2024

Important reminder: The correct original claim number must be included if submitting a corrected claim

Education & TrainingMedicaidApril 1, 2024

New digital platform for eLearning

Policy Updates

Medical Policy & Clinical GuidelinesMedicaidMarch 18, 2024

Clinical Criteria updates — December 2023

Medical Policy & Clinical GuidelinesMedicare AdvantageMarch 4, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Prior AuthorizationCommercialMarch 12, 2024

Anthem Precertification List Change Notification for September 2023

Prior AuthorizationMedicare AdvantageMarch 11, 2024

Prior authorization requirement changes effective July 1, 2024

Prior AuthorizationCommercialMedicare AdvantageMarch 20, 2024

Carelon Medical Benefits Management, Inc. genetic testing code updates

Prior AuthorizationCommercialMarch 27, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs

Reimbursement PoliciesCommercialApril 1, 2024

Reimbursement policy update: Virtual Visits — Professional and Facility

Products & Programs

PharmacyMedicare AdvantageMarch 22, 2024

Expansion of specialty pharmacy precertification list

PharmacyMedicaidMarch 6, 2024

Prior authorization updates for medications billed under the medical benefit

Elfabrio, Epkinly, Qalsody, Vyjuvek, and Zynyz

Quality Management

Quality ManagementCommercialMedicare AdvantageMarch 8, 2024

HEDIS® 2024 documentation for Colorectal Cancer Screening (COL-E)

Quality ManagementMedicaidMarch 8, 2024

HEDIS® 2024 documentation for Colorectal Cancer Screening (COL-E)

NYBCBS-CDCRCM-053373-24

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).