CommercialMedicare AdvantageMedicaid Managed CareAugust 1, 2023
August 2023 Provider News
Featured Articles
CommercialMedicare AdvantageAugust 1, 2023
Looking to earn CME credits? Check out the CME Engagement Hub!
CommercialMedicare AdvantageAugust 1, 2023
Reminder: Start using the Provider Data Management application now on Availity Essentials — retirement of previous intake channels October 1, 2023
Administrative
CommercialAugust 1, 2023
Anthem Blue Cross and Blue Shield appropriate coding helps provide a comprehensive picture of patients’ health and services providedMedicaid Managed CareAugust 1, 2023
Clinical Laboratory Improvement AmendmentsCommercialAugust 1, 2023
Unspecified diagnosis code of site and lateralityCommercialMedicare AdvantageAugust 1, 2023
Clinical Laboratory Improvement AmendmentsMedicare AdvantageJuly 18, 2023
Urinary tract infection tool kits are on the wayMedicaid Managed CareAugust 1, 2023
Provider Orientation dates - Summer 2023CommercialAugust 1, 2023
Federal Consolidated Appropriations Act (CAA) Gag ClauseCommercialAugust 1, 2023
CAA: Review your online provider directory information regularlyMedicaid Managed CareAugust 1, 2023
Claims escalation, disputes, and appeals processPolicy Updates
Medicare AdvantageJune 29, 2023
Clinical Criteria updates - March 2023CommercialJuly 21, 2023
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Updates to Carelon Medical Benefits Management, Inc. Joint Surgery, Small Joint Surgery, and MSK Level of CareMedicare AdvantageJuly 25, 2023
Prior authorization requirement changes effective November 1, 2023Medicaid Managed CareJuly 14, 2023
PA and Step therapy update - VegzelmaMedicaid Managed CareJuly 13, 2023
Prior authorization requirement changes effective September 1, 2023Medicaid Managed CareJune 28, 2023
Prior authorization requirement changes effective August 1, 2023Medicaid Managed CareAugust 1, 2023
Technology Assisted Surgical ProceduresMedicare AdvantageAugust 1, 2023
Technology Assisted Surgical ProceduresProducts & Programs
CommercialAugust 1, 2023
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Specialty pharmacy updates - August 2023CommercialAugust 1, 2023
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Specialty pharmacy updates - August 2023Medicaid Managed CareJuly 17, 2023
Prior authorization update: Byooviz, Cimerli, Fylnetra, Rolvedon, and StimufendCommercialAugust 1, 2023
Pharmacy information available on our provider websiteMedicare AdvantageAugust 1, 2023
Medication adherence: Back to the basicsMedicare AdvantageAugust 1, 2023
Why statin therapy is important in your patients with diabetesQuality Management
Medicare AdvantageAugust 1, 2023
Healthy blood pressure recheck initiativeMedicare AdvantageAugust 1, 2023
Healthy blood pressure recheck initiativeMedicaid Managed CareAugust 1, 2023
Important information about utilization managementMedicaid Managed CareAugust 1, 2023
Members’ Rights and ResponsibilitiesMedicaid Managed CareAugust 1, 2023
Complex Case Management ProgramCommercialMedicare AdvantageMedicaid Managed CareJuly 17, 2023
Pharmacotherapy Management of COPD Exacerbation (PCE) HEDIS® MeasureCommercialMedicaid Managed CareAugust 1, 2023
Congenital syphilis is a sentinel health eventOHBCBS-CDCRCM-030308-23
Availity, LLC is an independent company providing administrative support services on behalf of the health plan. Carelon Medical Benefits Management, Inc. is an independent company providing utilization management services on behalf of the health plan.
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