June 1, 2025

June 2025 Provider Newsletter

Filter By: AllCommercialMedicare AdvantageMedicaid Managed Care

Featured Articles

Education & TrainingMedicare AdvantageMay 27, 2025

Learn about annual Model of Care training for special needs plans

Education & TrainingCommercialJune 1, 2025

Availity Essentials Provider Overpayments application launch

Education & TrainingCommercialMedicare AdvantageMay 27, 2025

Boost your roster submission skills with Availity Essentials

Administrative

AdministrativeCommercialMedicare AdvantageJune 1, 2025

LabCorp and Quest Diagnostics are in-network — reminder

AdministrativeCommercialJune 1, 2025

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

Update to Chargemaster Audit Process

AdministrativeCommercialJune 1, 2025

Update to claims system for global surgical procedures for professional providers

AdministrativeCommercialJune 1, 2025

Upcoming changes to the provider manual effective September 2025

Digital SolutionsCommercialMedicare AdvantageMedicaid Managed CareJune 1, 2025

Submitting BH authorizations in Availity Essentials

Digital SolutionsCommercialMedicare AdvantageMarch 1, 2025

Reminder: provider data attestation

Education & Training

Education & TrainingMedicare AdvantageJune 1, 2025

Bridging the gap: enhancing medication adherence for better health outcomes

Education & TrainingMedicare AdvantageJune 1, 2025

Claims guidance: updating inpatient and outpatient bill types

WebinarsCommercialMedicare AdvantageMedicaid Managed CareJune 1, 2025

Registration is now available for our upcoming CME webinar on Integrating Cancer Care

Policy Updates

Policy UpdatesMedicare AdvantageMay 13, 2025

Clinical Criteria updates

Effective June 20, 2025

Medical Policy & Clinical GuidelinesMedicaid Managed CareMay 21, 2025

Medical Policies and Clinical Utilization Management Guidelines update

Effective June 25, 2025

Products & Programs

PharmacyCommercialJune 1, 2025

Unlock updated pharmacy insights today — visit our provider website

PharmacyMedicare AdvantageMay 22, 2025

New specialty pharmacy medical step therapy requirements

Effective July 1, 2025
Pavblu, Ahzantive, Enzeevu, Opuviz, and Yesafili

PharmacyMedicaid Managed CareMay 20, 2025

Prior authorization updates for medications billed under the medical benefit

Effective July 1, 2025
Tevimbra and Tyenne

Quality Management

Quality ManagementMedicaid Managed CareJune 1, 2025

Insights on utilization management

Quality ManagementMedicaid Managed CareJune 1, 2025

Your patients' healthcare journey: understanding their rights and responsibilities

Quality ManagementMedicaid Managed CareJune 1, 2025

How care providers can support members in challenging times

OHBCBS-CDCRCM-083884-25-CPN83757