CommercialMedicare AdvantageMedicaidNovember 1, 2024

November 2024 Provider Newsletter

Featured Articles

Quality ManagementCommercialMedicare AdvantageMedicaidOctober 25, 2024

Time to prepare for HEDIS medical record review

AdministrativeCommercialOctober 23, 2024

Do you offer telehealth services? Let us know!

Education & TrainingMedicare AdvantageOctober 15, 2024

Model of Care training reminder


Administrative

AdministrativeCommercialOctober 1, 2024

Physician Access/Appointment Availability Standards

AdministrativeCommercialNovember 1, 2024

Personalized Match update

Behavioral Health

Behavioral HealthCommercialNovember 1, 2024

Introducing a new Applied Behavior Analysis Provider Resource Guide

Education & Training

Education & TrainingMedicaidNovember 1, 2024

After hours for primary care physicians

Policy Updates

Policy UpdatesMedicare AdvantageSeptember 25, 2024

Carelon Medical Benefits Management, Inc. updates

Effective November 17, 2024

Policy UpdatesMedicaidSeptember 30, 2024

Carelon Medical Benefits Management, Inc. updates

Effective November 30, 2024

Medical Policy & Clinical GuidelinesMedicaidOctober 2, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Effective November 3, 2024

Prior AuthorizationCommercialNovember 1, 2024

Precertification List Change Notification — November 1, 2024

Codes J3393 and J3394

Prior AuthorizationCommercialNovember 1, 2024

Precertification List Change Notification — November 1, 2024

Prior AuthorizationMedicaidOctober 10, 2024

Prior authorization requirement changes

Effective December 1, 2024

Prior AuthorizationMedicare AdvantageSeptember 24, 2024

Prior authorization requirement changes

Effective February 1, 2025

Reimbursement PoliciesCommercialNovember 1, 2024

Reimbursement policy update: Nurse Practitioner and Physician Assistant Services

Products & Programs

PharmacyCommercialJuly 1, 2024

Correction: Specialty pharmacy updates — July 2024

PharmacyCommercialOctober 24, 2024

Specialty pharmacy updates — November 2024

PharmacyCommercialNovember 1, 2024

Clinical Criteria updates for specialty pharmacy

PharmacyMedicare AdvantageNovember 1, 2024

Improving patient outcomes: back to the basics

Quality Management

Quality ManagementMedicaidOctober 24, 2024

Provider: CAHPS awareness

NYBCBS-CDCRCM-070463-24

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