CommercialMedicare AdvantageMedicaidJune 30, 2023
July 2023 Provider Newsletter
Featured Articles
CommercialJune 30, 2023
Requests for Additional Information are now digital
CommercialMedicare AdvantageMedicaidJune 30, 2023
Provider data management capability now available on Availity Essentials — retirement of previous intake channels October 1, 2023
CommercialJune 22, 2023
Newborn authorizations and baby names
CommercialMedicare AdvantageMedicaidJune 30, 2023
Advancing health equity: Leveraging data to promote meaningful patient-provider relationships
Administrative
CommercialJune 30, 2023
Notification of NCCI review of medically unlikely editsMedicare AdvantageMedicaidJune 30, 2023
Unspecified diagnosis code of site and lateralityCommercialJune 30, 2023
Maintain your online provider directory informationCommercialMedicare AdvantageMedicaidJune 30, 2023
Home Health Agency Capabilities surveyMedicaidJune 12, 2023
New Digital Provider Enrollment tool added to Availity EssentialsEducation & Training
CommercialMedicare AdvantageJune 30, 2023
The BlueCard Provider Manual can answer your questions about the programMedicare AdvantageJune 30, 2023
Required training - Model of CarePolicy Updates
MedicaidJune 12, 2023
Clinical Criteria updates for February 2023MedicaidJune 9, 2023
Clinical Criteria updates for December 2022Medicare AdvantageJune 26, 2023
Medical Policies and Clinical Utilization Management Guidelines update for February 2023CommercialJune 30, 2023
Medical Policy and Clinical Guideline updatesCommercialJune 21, 2023
Expansion of Carelon Medical Benefits Management, Inc. Cardiology program clinical appropriateness review for Pacemakers programMedicaidJune 26, 2023
Medical Prior Authorization update Fylnetra, Rolvedon, and StimufendMedicaidMay 31, 2023
Cimerli Medical Prior Authorization updateMedicaidJune 12, 2023
Carelon MSK - Spine Surgery Code updates effective November 1, 2023CommercialJune 30, 2023
Carelon Medical Benefits Management, Inc. Genetic Testing CPT Code List updateMedicare AdvantageJune 5, 2023
Carelon Medical Benefits Management, Inc. genetic testing CPT code list updateMedicaidJune 5, 2023
Carelon Medical Benefits Management, Inc. genetic testing CPT code list updateMedicaidJune 1, 2023
Spevigo and Xenpozyme Medical Prior Authorization updateCommercialJune 30, 2023
Reimbursement policy update: Prolonged Services — ProfessionalCommercialJune 30, 2023
New reimbursement policy Multiple Procedure Payment Reduction — ProfessionalProducts & Programs
Medicare AdvantageJune 26, 2023
Medicare Part B precert expansion may multiple drug alignmentCommercialJune 30, 2023
Clinical Criteria updates for specialty pharmacyNYBCBS-CDCRCM-027109-23
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