CommercialMedicare AdvantageMedicaidNovember 1, 2023

November 2023 Provider Newsletter

Featured Articles

Digital SolutionsCommercialOctober 31, 2023

Digital RFAI process improvements

Education & TrainingCommercialMedicaidOctober 31, 2023

Practitioners’ rights during credentialing process


Administrative

AdministrativeMedicare AdvantageDecember 1, 2023

Updates to correct coding editing

AdministrativeCommercialOctober 31, 2023

Emergency Department Post-Pay Review Protocol

AdministrativeMedicare AdvantageOctober 31, 2023

Usage of liability modifiers

AdministrativeMedicaidSeptember 28, 2023

Reminder — New York State Medicaid DME

AdministrativeCommercialOctober 31, 2023

NY 2022 AB372 - Prohibits Copayments for Opioid Treatment Programs

AdministrativeCommercialOctober 31, 2023

CAA: Maintain your online provider directory information

Digital SolutionsCommercialMedicare AdvantageMedicaidOctober 31, 2023

Introducing Claims Status enhancements for claim inquiries

Digital SolutionsCommercialMedicare AdvantageOctober 31, 2023

Improvements to secure messaging through Availity Essentials

Digital SolutionsCommercialOctober 31, 2023

Filing digital claims disputes: Transparent and trackable

Education & Training

Education & TrainingMedicaidOctober 31, 2023

State communication: Foster Care Provider Education Update

Policy Updates

Medical Policy & Clinical GuidelinesMedicare AdvantageNovember 1, 2023

Carelon Medical Benefits Management, Inc. updates - November 2023

Prior AuthorizationMedicare AdvantageOctober 19, 2023

Expansion of Carelon Medical Benefits Management, Inc. programs

Prior AuthorizationMedicaidOctober 24, 2023

Prior authorization update - Lamzede, Lunsumio, Rebyota, etc.

Prior AuthorizationMedicare AdvantageOctober 16, 2023

RETRACTION: Prior authorization requirement changes effective February 1, 2024 

Codes 32274 and 32275

Prior AuthorizationMedicare AdvantageOctober 3, 2023

Prior authorization requirement changes effective February 1, 2024 - code J1411

Products & Programs

Federal Employee Program (FEP)CommercialOctober 31, 2023

Federal Employee Program specialty pharmacy prior authorization review

Federal Employee Program (FEP)CommercialOctober 31, 2023

FEP® Specialty Pharmacy prior authorization list

PharmacyCommercialOctober 31, 2023

Clinical Criteria updates for specialty pharmacy

PharmacyCommercialOctober 31, 2023

Specialty pharmacy updates

PharmacyCommercialOctober 31, 2023

Pharmacy information available on our provider website

Quality Management

Quality ManagementCommercialMedicare AdvantageMedicaidOctober 31, 2023

Controlling high blood pressure and HEDIS

Quality ManagementCommercialMedicare AdvantageMedicaidOctober 25, 2023

HEDIS measurement year 2023 documentation for Childhood Immunization Status (CIS)

Quality ManagementCommercialMedicare AdvantageMedicaidOctober 15, 2023

HEDIS medical record submission made easier with our Remote EMR Access Service

Quality ManagementCommercialMedicare AdvantageMedicaidOctober 31, 2023

HEDIS measurement year 2023 documentation for Transitions of Care (TRC)

Quality ManagementCommercialMedicare AdvantageMedicaidSeptember 27, 2023

Be Antibiotics Aware: Protect your patients

Quality ManagementMedicare AdvantageOctober 31, 2023

Statin therapy end of year best practices

NYBCBS-CDCRCM-041573-23

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