CommercialMedicare AdvantageMedicaid Managed CareJanuary 1, 2024

January 2024 Provider Newsletter

Featured Articles

Digital SolutionsCommercialDecember 26, 2023

Training for digital requests for additional information (Digital RFAI)

Education & TrainingCommercialJanuary 1, 2024

Important information about your Anthem patients’ specialty prescriptions

Quality ManagementCommercialNovember 20, 2023

Annual preventive care visits


Administrative

AdministrativeMedicaid Managed CareJanuary 1, 2024

New resources available for ePRAF

AdministrativeMedicaid Managed CareJanuary 1, 2024

New Sandata Mobile Connect app for EVV providers

AdministrativeCommercialJanuary 1, 2024

Using and billing air ambulance services appropriately

AdministrativeCommercialJanuary 1, 2024

CAA: Maintain your online provider directory information

AdministrativeMedicare AdvantageJanuary 1, 2024

Inappropriate primary diagnosis

AdministrativeMedicaid Managed CareJanuary 1, 2024

Inappropriate primary diagnosis

Education & Training

Education & TrainingMedicaid Managed CareMarch 31, 2023

Ready, set, renew!

Education & TrainingMedicaid Managed CareJanuary 1, 2024

Anthem Blue Cross and Blue Shield provider orientations

Policy Updates

Medical Policy & Clinical GuidelinesMedicare AdvantageDecember 1, 2023

Clinical Criteria updates — August 2023

Medical Policy & Clinical GuidelinesMedicare AdvantageJanuary 1, 2024

Genetic testing code list update

Medical Policy & Clinical GuidelinesCommercialMedicare AdvantageDecember 28, 2023

Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements

Transition to Carelon Medical Benefits Management, Inc. cardiology guidelines

Medical Policy & Clinical GuidelinesCommercialMedicare AdvantageJanuary 1, 2024

Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements

Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness Guidelines

Medical Policy & Clinical GuidelinesCommercialJanuary 1, 2024

Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements

Carelon Medical Benefits Management, Inc. genetic testing CPT® code list update

Prior AuthorizationCommercialJanuary 1, 2024

Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements

Expansion of Carelon Medical Benefits Management, Inc. programs effective April 1, 2024

Prior AuthorizationMedicare AdvantageJanuary 10, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs effective April 1, 2024

Prior AuthorizationMedicaid Managed CareDecember 7, 2023

Notice of Material Amendment: Prior authorization requirement changes

Products & Programs

DentalCommercialJanuary 1, 2024

January Dental newsletter communications

PharmacyCommercialDecember 28, 2023

Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements

Specialty pharmacy updates — January 2024

Quality Management

Quality ManagementMedicare AdvantageJanuary 1, 2024

Boost annual planned visit rates

Quality ManagementCommercialMedicare AdvantageJanuary 1, 2024

HEDIS diabetes documentation

Quality ManagementMedicaid Managed CareJanuary 1, 2024

HEDIS diabetes documentation

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