CommercialMedicare AdvantageMedicaidSeptember 1, 2023
September 2023 Provider Newsletter
Featured Articles
CommercialMedicare AdvantageMedicaidAugust 17, 2023
Reminder: The Empire name is transitioning to Anthem
CommercialSeptember 1, 2023
HCPCS to revenue code alignment
Administrative
CommercialSeptember 1, 2023
Support documentation for Carelon Medical Benefits Management, Inc. prior authorization requestsCommercialSeptember 1, 2023
CAA: Have you reviewed your online provider directory information lately?CommercialSeptember 1, 2023
CORRECTION: Regarding Notification About Submitting Itemized BillsCommercialSeptember 1, 2023
Consider a FIT kit for your patients aged 45 and older at average risk for colon cancerCommercialSeptember 1, 2023
Simplifying claims attachments: Digital Request for Additional Information through Availity.comMedicare AdvantageSeptember 1, 2023
Personalized match phase 1: Specialist provider overviewCommercialSeptember 1, 2023
Improvements to Digital RFAI Attachment filtering and reportingCommercialSeptember 1, 2023
Member search feature enhancement: Search for a patient without using member ID in Availity EssentialsPolicy Updates
MedicaidAugust 25, 2023
Clinical Criteria updates - May 2023Medicare AdvantageAugust 9, 2023
Clinical Criteria Updates - May 2023MedicaidAugust 14, 2023
New York State Medicaid billing guidance for COVID-19 testing, specimen collection, and therapeuticsMedicare AdvantageJuly 20, 2023
Provider notification — prepay itemization bill reviewMedicaidSeptember 1, 2023
Existing New York State Medicaid policy for drugs, supplies, and procedures used for sexual or erectile dysfunctionCommercialSeptember 1, 2023
Precertification list change notification for September 2023CommercialSeptember 1, 2023
Carelon Medical Benefits Management Expanded Musculoskeletal Review Program — effective December 29, 2023CommercialSeptember 1, 2023
Authorizations for post-acute care services for Commercial membersCommercialMedicare AdvantageMay 24, 2023
Carelon Medical Benefits Management, Inc. advanced imaging — Imaging of the brain CPT code list updateMedicaidJuly 26, 2023
Prior authorization requirement changes effective September 1, 2023MedicaidAugust 9, 2023
Prior authorization requirement changes effective October 1, 2023Medicare AdvantageAugust 7, 2023
Prior authorization requirement changes effective December 1, 2023CommercialSeptember 1, 2023
Reimbursement policy update: Documentation Standards for Episodes of Care — ProfessionalCommercialSeptember 1, 2023
Reimbursement policy update: Place of Service – FacilityCommercialSeptember 1, 2023
Clarification to reimbursement policy update: Prolonged Services – ProfessionalProducts & Programs
MedicaidSeptember 1, 2023
Oral health and chronic disease — The connection is realCommercialSeptember 1, 2023
Clinical Criteria updates for specialty pharmacyCommercialSeptember 1, 2023
Sublocade® updateCommercialSeptember 1, 2023
Specialty pharmacy updates – September 2023MedicaidAugust 2, 2023
PA update - AltuviiioMedicare AdvantageAugust 3, 2023
Specialty pharmacy medical step therapy for hyaluronan injectionsMedicare AdvantageJuly 28, 2023
UPDATED: Empire BlueCross BlueShield expands specialty pharmacy precertification listQuality Management
MedicaidSeptember 1, 2023
Consider a FIT kit for patients at average risk for colon cancerMedicare AdvantageSeptember 1, 2023
Medication reconciliation post inpatient dischargeNYBCBS-CDCRCM-035546-23
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