July 1, 2025
July 2025 Provider Newsletter
Filter By: AllCommercialMedicare AdvantageMedicaid Managed Care
Featured Articles
CommercialJune 13, 2025
Streamlined claim submission process update
CommercialJuly 1, 2025
Enroll with Availity to verify your provider data
CommercialMedicare AdvantageMedicaid Managed CareJuly 1, 2025
Join the 2025 Clinical Quality in Practice webinar series
Administrative
Medicare AdvantageJuly 1, 2025
A quick guide to understanding JW and JZ modifiersCommercialJuly 1, 2025
A quick guide to understanding JW and JZ modifiersMedicare AdvantageJuly 1, 2025
Implementation of chargemaster‑based claims edit for ER levelingMedicare AdvantageJune 23, 2025
Essential information for providers: understanding Medicare Advantage group retiree plansCommercialJuly 1, 2025
View your Fee Schedule in Availity Essentials Payer SpacesCommercialJuly 1, 2025
Update: essential ICD‑10‑CM compliance for outpatient facility claimsCommercialMedicare AdvantageMedicaid Managed CareJuly 1, 2025
Seamless Provider Enrollment and Network Management through Availity Essentials optimizes the care provider experienceCommercialMedicare AdvantageMedicaid Managed CareJuly 1, 2025
Streamlining behavioral health authorizations via Availity EssentialsMedicare AdvantageJune 17, 2025
Specialty pharmacy precertification list expansion — key updatesEducation & Training
Medicaid Managed CareJuly 1, 2025
You are invited: Provider Engagement Council meetingMedicare AdvantageJuly 1, 2025
Combat diabetes: Close the statin therapy gap for better heart healthPolicy Updates
Medicaid Managed CareJune 9, 2025
Precertification/prior authorization requirement changesEffective August 1, 2025
Medicare AdvantageJune 3, 2025
Precertification/prior authorization requirement changesEffective November 1, 2025
CommercialJuly 1, 2025
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
New reimbursement policy: Code and Clinical Editing Guidelines — Professional and FacilityCommercialJuly 1, 2025
Reimbursement policy update: Nurse Practitioner and Physician Assistant servicesMedicaid Managed CareJuly 1, 2025
Reimbursement Policy Update: Multiple Radiology Payment ReductionProducts & Programs
CommercialMay 30, 2025
Key updates to the Designated Medical Specialty Pharmacy Drug ListEffective August 1, 2025
Blincyto
CommercialJune 2, 2025
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Specialty pharmacy updates: June 2025OHBCBS-CDCRCM-085817-25-CPN85703
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