Key Updates
CommercialMedicare AdvantageNovember 1, 2024
Roster Automation updates: roster download functionality
CommercialMedicare AdvantageMedicaid Managed CareOctober 25, 2024
Time to prepare for HEDIS medical record review
Medicaid Managed CareOctober 23, 2024
Provider data accuracy
Medicaid Managed CareOctober 23, 2024
Reminder: take action to protect infants from respiratory syncytial virus this season
CommercialOctober 23, 2024
Do you offer telehealth services? Let us know!
Medicare AdvantageOctober 15, 2024
Model of Care training reminder
Recent Updates
Medicaid Managed CareNovember 21, 2024
Medical Policies and Clinical Utilization Management Guidelines updateEffective January 1, 2025
CommercialNovember 21, 2024
Expansion of Carelon Medical Benefits Management, Inc. programsMedicare AdvantageNovember 18, 2024
Ohio 2025 Medicare Advantage plan changesCommercialNovember 18, 2024
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Specialty pharmacy updates — December 2024Medicare AdvantageNovember 18, 2024
Expansion of Carelon Medical Benefits Management, Inc. programsMedicare AdvantageNovember 18, 2024
Notice of change: Part D Rx HCCsMedicare AdvantageNovember 15, 2024
Skilled nursing facility — vaccine serum compensationMedicare AdvantageNovember 14, 2024
Medicare Part D overhaul: What's new in 2025 for your prescription drug costs?Medicaid Managed CareNovember 12, 2024
Prior authorization requirement changesEffective January 1, 2025
Medicaid Managed CareNovember 8, 2024
Program date change announcementCommercialMedicare AdvantageNovember 1, 2024
Roster Automation updates: roster download functionalityCommercialNovember 1, 2024
Personalized Match updateMedicaid Managed CareNovember 1, 2024
You are invited: Provider orientationMedicaid Managed CareNovember 1, 2024
You are invited: Hospice education webinarMedicaid Managed CareNovember 1, 2024
You are invited: Behavioral health provider orientationMedicare AdvantageNovember 1, 2024
Improving patient outcomes: back to the basicsCommercialNovember 1, 2024
More error types for corrected claims submitted through EDI now availableCommercialNovember 1, 2024
Submit corrected claims electronically for the Federal Employee Program®CommercialNovember 1, 2024
Reimbursement policy reminder: Multiple Surgery — FacilityMedicaid Managed CareNovember 1, 2024
Behind the scenes, get to know: Patrick StoneCommercialNovember 1, 2024
New claims requirement: add-on codes must include primary procedure starting December 2024CommercialNovember 1, 2024
Adopting digital member ID cardsCommercialNovember 1, 2024
High Performing and Blue National Designated Providers may also be known as Anthem Diamond ProvidersCommercialNovember 1, 2024
Introducing a new Applied Behavior Analysis Provider Resource GuideMedicaid Managed CareNovember 1, 2024
Enhanced personalized match: making the care provider search more informed and personalizedCommercialNovember 1, 2024
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Reimbursement policy update: Nurse Practitioner and Physician Assistant ServicesMedicare AdvantageMedicaid Managed CareOctober 29, 2024
HEDIS Measure Tips — Appropriate Treatment for Upper Respiratory Infection (URI) 2025CommercialMedicare AdvantageMedicaid Managed CareOctober 25, 2024
Time to prepare for HEDIS medical record reviewCommercialOctober 24, 2024
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Specialty pharmacy updates — November 2024Medicaid Managed CareOctober 24, 2024
Provider: CAHPS awarenessMedicaid Managed CareOctober 23, 2024
Provider data accuracyMedicaid Managed CareOctober 23, 2024
Reminder: take action to protect infants from respiratory syncytial virus this seasonCommercialMedicare AdvantageOctober 23, 2024
HEDIS Measure Tips — Appropriate Testing for Pharyngitis (CWP) 2025CommercialOctober 23, 2024
Do you offer telehealth services? Let us know!Medicaid Managed CareOctober 22, 2024
Medical Policies and Clinical Utilization Management Guidelines updateEffective December 1, 2024
CommercialMedicare AdvantageOctober 22, 2024
HEDIS Measure Tips — Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB) 2025CommercialOctober 21, 2024
Notification of authorization fax number changesMedicare AdvantageOctober 16, 2024
Clarification to Carelon Medical Benefits Management, Inc. updates effective September 1, 2024Medicaid Managed CareOctober 15, 2024
Updated guidance for Immunizations Covered by Vaccines for ChildrenMedicare AdvantageOctober 15, 2024
Model of Care training reminderMedicaid Managed CareOctober 10, 2024
Prior authorization requirement changesEffective December 1, 2024
Medicaid Managed CareOctober 9, 2024
Prior authorization requirement changesEffective December 1, 2024
CommercialMedicare AdvantageOctober 7, 2024
HEDIS Measure Tips — Cardiac Rehabilitation (CRE) 2025Medicaid Managed CareOctober 7, 2024
Provider reference guide: claims disputes and appeals, and clinical appeals for UM decisionsMedicare AdvantageOctober 4, 2024
HEDIS Measure Tips — Adults’ Access to Preventive/Ambulatory Health Services (AAP) 2025CommercialMedicare AdvantageOctober 3, 2024
Blood Pressure Control for Patients With Diabetes (BPD) 2025Medicare AdvantageOctober 2, 2024
Pharmacotherapy Management of COPD Exacerbation (PCE) 2025Medicare AdvantageOctober 1, 2024
Introducing the Care Provider Recognition Program from Anthem