CommercialMedicare AdvantageMedicaidJuly 1, 2024

July 2024 Provider Newsletter

Featured Articles


Administrative

AdministrativeMedicaidJuly 1, 2024

Anatomical modifiers

AdministrativeCommercialJuly 1, 2024

Recovery room — facility editing update

AdministrativeCommercialJuly 1, 2024

Anesthesia modifiers — professional editing update

AdministrativeCommercialJuly 1, 2024

Drugs and biologic

AdministrativeCommercialMedicare AdvantageMedicaidJune 18, 2024

Phoenix Sepsis Criteria for coding and billing pediatric sepsis

AdministrativeCommercialJuly 1, 2024

CAA: Maintain your online provider directory information

Digital SolutionsCommercialJune 20, 2024

Digital-only authorization case status notification coming to you

Education & Training

Education & TrainingCommercialJune 13, 2024

Faster notification of EDI corrected claims errors

Education & TrainingMedicaidJune 21, 2024

Human papillomavirus vaccinations facts

Education & TrainingCommercialMedicare AdvantageMedicaidJuly 1, 2024

July is Disability Awareness Month

Education & TrainingMedicaidJune 4, 2024

Childhood immunization status (CIS)

Education & TrainingMedicaidJune 4, 2024

Immunizations for Adolescents (IMA)

Policy Updates

Policy UpdatesMedicaidMay 29, 2024

Clinical Criteria updates

Effective June 29, 2024

Policy UpdatesMedicare AdvantageJune 4, 2024

Clinical Criteria updates

Effective July 6, 2024

Policy UpdatesMedicare AdvantageJune 3, 2024

Clinical Criteria updates — November 2023

Policy UpdatesMedicaidJune 4, 2024

Carelon Medical Benefits Management, Inc. updates

Policy UpdatesMedicare AdvantageMay 29, 2024

Carelon Medical Benefits Management, Inc. updates

Medical Policy & Clinical GuidelinesMedicare AdvantageJune 21, 2024

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

Medical Policy & Clinical GuidelinesCommercialMedicaidJune 28, 2024

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

Medical Policy & Clinical GuidelinesCommercialJuly 1, 2024

Medical Policy and Clinical Guideline updates

Medical Policy & Clinical GuidelinesMedicare AdvantageMay 30, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Effective July 1, 2024

Medical Policy & Clinical GuidelinesMedicaidJune 12, 2024

MCG Care Guidelines 28th edition

Prior AuthorizationCommercialJune 19, 2024

Carelon Medical Benefits Management, Inc. genetic testing code updates

Prior AuthorizationMedicaidJune 20, 2024

Prior authorization requirement changes effective August 1, 2024

Code C9790

Prior AuthorizationCommercialJuly 1, 2024

Precertification list change notification

Prior AuthorizationCommercialJuly 1, 2024

Precertification list change notification July 1, 2024

Prior AuthorizationCommercialMay 7, 2024

Anthem Precertification List Change Notification for July 1, 2024

Products & Programs

Federal Employee Program (FEP)CommercialJuly 1, 2024

Antidepressant Medication Management (AMM)

Quality Management

Quality ManagementMedicare AdvantageJuly 1, 2024

Understanding your role in the Health Outcomes Survey

Quality ManagementMedicaidJuly 1, 2024

Complex Case Management program

Quality ManagementMedicaidJuly 1, 2024

Important information about utilization management

Quality ManagementMedicaidJuly 1, 2024

Member Rights and Responsibilities statement

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