CommercialMedicare AdvantageMedicaid Managed CareJuly 1, 2024
July 2024 Provider Newsletter
Featured Articles
Medicare AdvantageMedicaid Managed CareJuly 1, 2024
Admission, discharge, and transfer information is now available for Medicare Advantage and Medicaid members
Medicaid Managed CareJuly 1, 2024
You are invited: Behavioral health provider orientation
Medicaid Managed CareJuly 1, 2024
You are invited: Provider orientation
Administrative
CommercialJuly 1, 2024
Timely receipt of other carrier EOB or rejection helps avoid timely filing denialsCommercialJuly 1, 2024
Anesthesia modifiers — professional editing updateCommercialJuly 1, 2024
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Drugs and biologicCommercialMedicare AdvantageMedicaid Managed CareJune 18, 2024
Phoenix Sepsis Criteria for coding and billing pediatric sepsisCommercialJuly 1, 2024
CAA: Maintain your online provider directory informationMedicaid Managed CareJanuary 1, 2024
New resources available for ePRAFMedicaid Managed CareJuly 1, 2024
Anatomical modifiersCommercialJune 20, 2024
Digital-only authorization case status notification coming to youEducation & Training
CommercialJune 13, 2024
Faster notification of EDI corrected claims errorsCommercialMedicare AdvantageMedicaid Managed CareJuly 1, 2024
July is Disability Awareness MonthMedicaid Managed CareJuly 1, 2024
Access instant health plan information via Availity EssentialsCommercialMarch 12, 2024
Important reminder: The correct original claim number must be included if submitting a corrected claimMedicaid Managed CareJuly 1, 2024
Join our Provider Advisory CouncilMedicaid Managed CareJuly 1, 2024
You are invited: Hospice education webinarPolicy Updates
Medicare AdvantageJune 3, 2024
Clinical Criteria updates — November 2023Medicare AdvantageMay 29, 2024
Carelon Medical Benefits Management, Inc. updatesCommercialMedicare AdvantageJune 27, 2024
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness GuidelinesCommercialJune 11, 2024
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Medical Policies and Clinical Guidelines updates for July 2024Medicare AdvantageMay 30, 2024
Medical Policies and Clinical Utilization Management Guidelines updateEffective July 1, 2024
Medicaid Managed CareJune 5, 2024
Medical Policies and Clinical Utilization Management Guidelines UpdateEffective July 7, 2024
CommercialJune 19, 2024
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Carelon Medical Benefits Management, Inc. genetic testing code updatesMedicaid Managed CareJune 20, 2024
Prior authorization requirement changes effective August 1, 2024Code C9790
Medicaid Managed CareJune 11, 2024
Prior authorization requirement changesEffective August 1, 2024
Codes 81173, 81247, 81249, 81307, 81336, 81403, 81405, and 81440
CommercialJuly 1, 2024
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Reimbursement policy update: Incident to Services — ProfessionalCommercialJuly 1, 2024
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Reimbursement policy update: Frequency Editing — ProfessionalCommercialJuly 1, 2024
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
New reimbursement policy: Diagnostic Radiopharmaceuticals and Contrast Materials — Professional and FacilityProducts & Programs
CommercialJuly 1, 2024
Antidepressant Medication Management (AMM)Medicare AdvantageJune 20, 2024
Anthem expands specialty pharmacy precertification listCommercialJuly 1, 2024
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Correction: Specialty pharmacy updates — July 2024Quality Management
Medicare AdvantageJuly 1, 2024
Understanding your role in the Health Outcomes SurveyOHBCBS-CDCRCM-061287-24
To view this publication online:
Visit https://providernews.anthem.com/ohio/publications/july-2024-provider-newsletter-2776-2776
Or scan this QR code with your phone