CommercialMedicare AdvantageMedicaid Managed CareAugust 1, 2024
August 2024 Provider Newsletter
Featured Articles
CommercialAugust 1, 2024
MCG Care Guidelines 28th edition
Medicaid Managed CareAugust 1, 2024
Provider revalidations
Administrative
Medicare AdvantageAugust 1, 2024
ICD-10-CM Excludes1 notesCommercialAugust 1, 2024
Device-dependent procedures — facility editing updateCommercialAugust 1, 2024
Incidental services — facility editing updateCommercialAugust 1, 2024
CAA: Providers required to verify their online provider directory informationMedicaid Managed CareAugust 1, 2024
Access instant health plan information via Availity EssentialsMedicaid Managed CareAugust 1, 2024
Mutually exclusive places of serviceMedicaid Managed CareJanuary 1, 2024
New resources available for ePRAFMedicaid Managed CareAugust 1, 2024
ICD-10-CM Excludes1 notesMedicaid Managed CareAugust 1, 2024
Behind the scenes, get to know: Kaitlyn NickelMedicaid Managed CareAugust 1, 2024
Reminder to submit claims with complete and accurateMedicare AdvantageJuly 16, 2024
Expansion of Carelon Medical Benefits Management, Inc. programsCommercialJuly 24, 2024
Expansion of Carelon Medical Benefits Management, Inc. programsBehavioral Health
Medicaid Managed CareAugust 1, 2024
Learn to Live: A Digital Mental Health Benefit for Anthem members!Education & Training
CommercialMedicare AdvantageMedicaid Managed CareAugust 1, 2024
Coming soon: Provider e-Learning Resource Center for Payment IntegrityCommercialMedicare AdvantageMedicaid Managed CareAugust 1, 2024
August is National Breastfeeding MonthMedicaid Managed CareAugust 1, 2024
Join our Provider Advisory CouncilMedicaid Managed CareJuly 1, 2024
Access instant health plan information via Availity EssentialsMedicaid Managed CareAugust 1, 2024
You are invited: Behavioral Health provider orientationMedicaid Managed CareAugust 1, 2024
You are invited: Hospice education webinarMedicaid Managed CareAugust 1, 2024
You are invited: Provider orientationPolicy Updates
Medicare AdvantageMedicaid Managed CareJuly 11, 2024
Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness GuidelinesCommercialJune 25, 2024
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Updates to Carelon Medical Benefits Management Clinical Appropriateness GuidelinesCommercialJuly 11, 2024
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Medical Policies and Clinical Guidelines updates — August 2024Medicare AdvantageJuly 5, 2024
Medical Policies and Clinical Utilization Management Guidelines updateEffective August 8, 2024
CommercialAugust 1, 2024
Notification of authorization fax number changesCommercialAugust 1, 2024
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
New reimbursement policy: Intraoperative Neuromonitoring — ProfessionalMedicare AdvantageAugust 1, 2024
Reimbursement policy update: Modifier 78CommercialAugust 1, 2024
Reimbursement policy update: Modifiers 26 and TC — ProfessionalCommercialAugust 1, 2024
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Reimbursement policy update: Professional Anesthesia ServiceCommercialAugust 1, 2024
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Reimbursement policy update: Bundled Services and Supplies — FacilityCommercialAugust 1, 2024
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Reimbursement policy update: Outpatient Facility Revenue Code Billing Requirements — FacilityMedicare AdvantageAugust 1, 2024
Reimbursement policy update: Nurse Practitioner and Physician Assistant ServicesMedicaid Managed CareAugust 1, 2024
Reimbursement policy update: Nurse Practitioner and Physician Assistant ServicesProducts & Programs
Medicaid Managed CareJuly 18, 2024
Prior authorization updates for medications billed under the medical benefitCommercialJuly 25, 2024
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Specialty pharmacy updates — February 2024Note: This article corrects the Clinical Criteria for Spravato (esketamine), which was incorrectly listed in a February 2024 article.
CommercialAugust 1, 2024
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Specialty pharmacy updates — August 2024Tevimbra, Tyenne, and Wezlana
OHBCBS-CDCRCM-063103-24
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