CommercialMedicare AdvantageMedicaid Managed CareJune 30, 2023

July 2023 Provider News

Featured Articles

Digital SolutionsCommercialMedicare AdvantageJune 30, 2023

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

Provider data management capability now available on Availity Essentials โ€” retirement of previous intake channels October 1, 2023

Products & ProgramsCommercialMedicare AdvantageJune 30, 2023

Advancing health equity: Leveraging data to promote meaningful patient-provider relationships


Administrative

AdministrativeMedicare AdvantageMedicaid Managed CareJune 30, 2023

Unspecified diagnosis code of site and laterality

AdministrativeCommercialJune 30, 2023

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

Notification of NCCI review of medically unlikely edits

AdministrativeMedicaid Managed CareMay 9, 2023

Provider Orientation Dates Summer 2023

AdministrativeCommercialJune 30, 2023

Maintain your online provider directory information

Behavioral Health

Behavioral HealthMedicaid Managed CareJune 30, 2023

You're invited: Connections Application Webinar

Behavioral HealthCommercialMedicare AdvantageMedicaid Managed CareJune 30, 2023

Important information regarding the recent Carelon Behavioral Health, Inc. assignment mailing

Education & Training

Education & TrainingCommercialJune 22, 2023

Newborn authorizations and baby names

Education & TrainingCommercialMedicare AdvantageJune 30, 2023

The BlueCard Provider Manual can answer your questions about the program

WebinarsMedicare AdvantageJune 30, 2023

Required training - Model of Care

Policy Updates

Medical Policy & Clinical GuidelinesMedicare AdvantageJune 26, 2023

Medical Policies and Clinical Utilization Management Guidelines update for February 2023

Medical Policy & Clinical GuidelinesCommercialJune 22, 2023

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

Expansion of Carelon Medical Benefits Management, Inc. Cardiology program clinical appropriateness review for Pacemakers program

Prior AuthorizationMedicaid Managed CareJune 30, 2023

Floor to SNF for in-network skilled nursing facilities

Prior AuthorizationCommercialJune 30, 2023

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 AuthorizationMedicare AdvantageJune 6, 2023

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

Reimbursement PoliciesCommercialJune 30, 2023

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

Reimbursement policy update: Prolonged Services โ€” Professional

Products & Programs

PharmacyMedicare AdvantageJune 26, 2023

Medicare Part B precert expansion may multiple drug alignment

OHBCBS-CDCRCM-027111-23