CommercialMedicare AdvantageMedicaidSeptember 1, 2023

September 2023 Provider Newsletter

Featured Articles

AdministrativeCommercialMedicare AdvantageMedicaidAugust 17, 2023

Reminder: The Empire name is transitioning to Anthem

AdministrativeCommercialSeptember 1, 2023

HCPCS to revenue code alignment


Policy Updates

Policy UpdatesMedicaidAugust 25, 2023

Clinical Criteria updates - May 2023

Policy UpdatesMedicare AdvantageAugust 9, 2023

Clinical Criteria Updates - May 2023

Policy UpdatesMedicare AdvantageJuly 20, 2023

Provider notification — prepay itemization bill review

Products & Programs

PharmacyCommercialSeptember 1, 2023

Clinical Criteria updates for specialty pharmacy

PharmacyCommercialSeptember 1, 2023

Sublocade® update

PharmacyCommercialSeptember 1, 2023

Specialty pharmacy updates – September 2023

PharmacyMedicaidAugust 2, 2023

PA update - Altuviiio

PharmacyMedicare AdvantageAugust 3, 2023

Specialty pharmacy medical step therapy for hyaluronan injections

Quality Management

Quality ManagementMedicaidSeptember 1, 2023

Consider a FIT kit for patients at average risk for colon cancer

Quality ManagementMedicare AdvantageSeptember 1, 2023

Medication reconciliation post inpatient discharge

NYBCBS-CDCRCM-035546-23

Carelon Medical Benefits Management, Inc. is an independent company providing utilization management services on behalf of the health plan. Availity, LLC is an independent company providing administrative support services on behalf of the health plan.