CommercialMedicare AdvantageMedicaidJanuary 1, 2024

January 2024 Provider Newsletter

Featured Articles

Digital SolutionsCommercialDecember 26, 2023

Training for digital requests for additional information (Digital RFAI)

Education & TrainingCommercialJanuary 1, 2024

Important information about your Anthem patients’ specialty prescriptions

Quality ManagementCommercialNovember 20, 2023

Annual preventive care visits


Administrative

AdministrativeCommercialJanuary 1, 2024

Using and billing air ambulance services appropriately

AdministrativeMedicaidDecember 15, 2023

Managed Long-Term Care office is moving

AdministrativeCommercialJanuary 1, 2024

CAA: Maintain your online provider directory information

AdministrativeMedicare AdvantageJanuary 1, 2024

Inappropriate primary diagnosis

AdministrativeMedicaidJanuary 1, 2024

Inappropriate primary diagnosis

Education & Training

Education & TrainingMedicaidJanuary 1, 2024

Provider Pathways — Learn all about it

Education & TrainingMedicaidMarch 31, 2023

Ready, set, renew!

Education & TrainingMedicaidNovember 30, 2023

CPT Category II update

Policy Updates

Medical Policy & Clinical GuidelinesMedicare AdvantageDecember 1, 2023

Clinical Criteria updates — August 2023

Medical Policy & Clinical GuidelinesMedicaidDecember 4, 2023

Clinical Criteria updates — August 2023

Medical Policy & Clinical GuidelinesMedicare AdvantageJanuary 1, 2024

Genetic testing code list update

Medical Policy & Clinical GuidelinesCommercialJanuary 1, 2024

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

Medical Policy & Clinical GuidelinesCommercialMedicare AdvantageMedicaidDecember 28, 2023

Transition to Carelon Medical Benefits Management, Inc. cardiology guidelines

Medical Policy & Clinical GuidelinesCommercialMedicare AdvantageMedicaidJanuary 1, 2024

Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness Guidelines

Prior AuthorizationMedicare AdvantageJanuary 10, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs effective April 1, 2024

Prior AuthorizationMedicaidDecember 19, 2023

Prior authorization requirement changes effective February 1, 2024

Codes 20979 and A7025

Prior AuthorizationMedicaidDecember 8, 2023

Prior authorization requirement changes effective February 1, 2024

Code J1411

Products & Programs

DentalCommercialJanuary 1, 2024

January Dental newsletter communications

PharmacyCommercialDecember 28, 2023

Specialty pharmacy updates — January 2024

Quality Management

Quality ManagementCommercialMedicare AdvantageMedicaidJanuary 1, 2024

HEDIS 2023 Electronic Clinical Data Systems (ECDS)

Quality ManagementMedicare AdvantageJanuary 1, 2024

Boost annual planned visit rates

NYBCBS-CDCRCM-047211-23

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