CommercialMedicare AdvantageMedicaid Managed CareJune 1, 2024

June 2024 Provider Newsletter

Featured Articles

Education & TrainingMedicaid Managed CareJune 1, 2024

You are invited: Provider orientation

Education & TrainingMedicaid Managed CareJune 1, 2024

Medicaid behavioral health orientation


Administrative

AdministrativeMedicaid Managed CareJanuary 1, 2024

New resources available for ePRAF

AdministrativeCommercialMedicare AdvantageMedicaid Managed CareJune 1, 2024

Availity Essentials single claim submission response reports

AdministrativeMedicaid Managed CareJune 1, 2024

Behind the scenes, get to know: Mallory Abazia

AdministrativeCommercialJune 1, 2024

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

Implant — Facility Editing update

AdministrativeCommercialJune 1, 2024

CAA: Review your online provider directory information

Digital SolutionsCommercialMedicare AdvantageMedicaid Managed CareMay 23, 2024

Digital RFAI Availity training

Digital SolutionsMedicare AdvantageApril 17, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs

Education & Training

Education & TrainingMedicaid Managed CareJune 1, 2024

Hepatitis C case management program

Education & TrainingCommercialMedicare AdvantageMedicaid Managed CareJune 1, 2024

June is LGBTQIA+ Pride Month

Education & TrainingCommercialMedicare AdvantageMedicaid Managed CareMay 23, 2024

You are invited: Thriving, not just surviving: navigating challenging times as a clinician

Education & TrainingCommercialMedicare AdvantageMedicaid Managed CareJune 1, 2024

Introducing advanced eLearning features for MyDiversePatients.com

Policy Updates

Medical Policy & Clinical GuidelinesCommercialMay 22, 2024

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

Medical Policies and Clinical Guidelines updates – June 2024

Medical Policy & Clinical GuidelinesMedicare AdvantageMay 7, 2024

Clinical Criteria updates

Effective June 10, 2024

Medical Policy & Clinical GuidelinesCommercialApril 30, 2024

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

MCG Care Guidelines 28th edition

Medical Policy & Clinical GuidelinesMedicare AdvantageMay 1, 2024

MCG Care Guidelines 28th edition

Medical Policy & Clinical GuidelinesCommercialMedicare AdvantageMay 3, 2024

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

Carelon Medical Benefits Management, Inc. genetic testing code updates

Medical Policy & Clinical GuidelinesCommercialMay 28, 2024

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

Updates to Carelon Post-Acute Care Clinical Appropriateness Guidelines

Prior AuthorizationCommercialJune 1, 2024

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

Expansion of Carelon Medical Benefits Management, Inc. programs

Products & Programs

PharmacyMedicare AdvantageJune 1, 2024

Addressing medication adherence gaps

PharmacyMedicare AdvantageJune 1, 2024

Improving patient outcomes with statin therapy in diabetes

PharmacyCommercialJune 1, 2024

Pharmacy information available on our provider website

Quality Management

Quality ManagementCommercialApril 19, 2024

Improving patient health and digital literacies

Quality ManagementCommercialMedicaid Managed CareMay 15, 2024

Tips to Improve Adolescent Immunization (IMA) Rates

Quality ManagementCommercialMedicare AdvantageMedicaid Managed CareJune 1, 2024

New resources to improve your HEDIS® and CAHPS® quality rates

Quality ManagementMedicaid Managed CareJune 1, 2024

Members’ Rights and Responsibilities Statement

Quality ManagementMedicaid Managed CareJune 1, 2024

Important information about utilization management

Quality ManagementMedicaid Managed CareJune 1, 2024

Complex Case Management program

Quality ManagementCommercialMay 6, 2024

Enhance patient access to digital health resources

OHBCBS-CDCRCM-059389-24

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).