CommercialMedicare AdvantageMedicaid Managed CareMarch 1, 2024
March 2024 Provider Newsletter
Administrative
Medicaid Managed CareJanuary 1, 2024
New resources available for ePRAFMedicare AdvantageMarch 1, 2024
CAA: Maintain your online provider directory informationMedicaid Managed CareMarch 1, 2024
Billing guidelines for Medicaid behavioral health providersMedicaid Managed CareJanuary 29, 2024
Provider revalidations resumed; immediate action requiredA message from Ohio Department of Medicaid
Medicaid Managed CareMarch 1, 2024
Availity Essentials Patient360CommercialFebruary 21, 2024
Beginning February 2024, you can submit Physical Health prior authorizations through the Authorization application on Availity.comCommercialMarch 1, 2024
Expansion of Carelon Medical Benefits Management, Inc. programsMedicare AdvantageFebruary 29, 2024
Expansion of Carelon Medical Benefits Management, Inc. programs effective April 1, 2024Medicaid Managed CareMarch 1, 2024
Behind the scenes, get to know: Danielle ClarkEducation & Training
CommercialMedicaid Managed CareMarch 1, 2024
Congenital syphilis intervention opportunities for neonatal and pediatric providersMedicaid Managed CareMarch 1, 2024
You are invited: Cultural competency and patient engagementMedicaid Managed CareMarch 1, 2024
Resources to support your diverse patient panelPolicy Updates
Medicaid Managed CareMarch 1, 2024
MCG Care Guidelines 28th editionMedicare AdvantageFebruary 20, 2024
Clinical Criteria updates — December 2023Medicare AdvantageMarch 1, 2024
Carelon Medical Benefits Management, Inc. genetic testing code updatesMedicare AdvantageFebruary 1, 2024
Prior authorization requirement changes effective May 1, 2024Codes G0481 - G0483
Medicare AdvantageJanuary 24, 2024
Prior authorization requirement changes effective May 1, 2024Code C1825
CommercialMarch 1, 2024
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Reimbursement policy update: Ambulance Transportation – ProfessionalProducts & Programs
Medicare AdvantageMarch 1, 2024
Overview of Medicare risk adjustment in-office prospective programsMedicare AdvantageFebruary 16, 2024
Anthem expands specialty pharmacy precertification listCommercialFebruary 20, 2024
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Prior authorization updates for therapeutic duplication of specialty drugsCommercialMarch 1, 2024
Pharmacy information available on our provider websiteCommercialMarch 1, 2024
Important information about your Anthem patients’ Botox prescriptionsMedicaid Managed CareFebruary 21, 2024
Prior authorization updates for medications billed under the medical benefitCommercialFebruary 22, 2024
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Specialty pharmacy updates — March 2024Medicare AdvantageJanuary 31, 2024
Notification of specialty pharmacy medical step therapy updatesQuality Management
Medicare AdvantageFebruary 7, 2024
HEDIS® 2024 documentation for Care of Older Adults (COA)CommercialMedicare AdvantageMedicaid Managed CareFebruary 6, 2024
HEDIS 2024 documentation for Controlling High Blood Pressure (CBP) and Statin Therapy for Patients with Cardiovascular Disease (SPC)CommercialMedicaid Managed CareMarch 1, 2024
Cervical Cancer Screening (CCS) and Prenatal and Postpartum Care (PPC) for HEDISCommercialMedicaid Managed CareMarch 1, 2024
Encourage Cervical Cancer Screening (CCS)CommercialMedicare AdvantageMedicaid Managed CareJanuary 29, 2024
HEDIS Breast Cancer Screening (BCS) updateOHBCBS-CDCRCM-051147-24
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