May 2, 2023

May 2023 Provider News

Filter By: AllCommercialMedicare AdvantageMedicaid Managed Care

Administrative

AdministrativeCommercialMay 1, 2023

Moving Toward Equity in Asthma Care

AdministrativeCommercialMedicare AdvantageMay 1, 2023

Looking to earn CME credits? Check out the CME Engagement Hub!

AdministrativeCommercialMedicare AdvantageMay 1, 2023

You are invited! Skilled Nursing Facility (SNF) providers: Fall prevention and patient safety

AdministrativeCommercialMay 1, 2023

Updates to standard facility code groups for CTs, MRIs, Mammograms *

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

Policy Updates

Policy UpdatesCommercialMedicaid Managed CareMay 1, 2023

Introducing www.myhealthbenefitfinder.com

Medical Policy & Clinical GuidelinesCommercialMay 1, 2023

Transition to Carelon Medical Benefits Management, Inc.* MRI Breast Clinical Appropriateness Guidelines*

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

Reimbursement PoliciesCommercialMay 1, 2023

Reimbursement policy update: Robotic Assisted Surgery – Professional*
*Notice of Material Amendment to Contract and/or Change to Prior Authorization Requirements

Reimbursement PoliciesCommercialMay 1, 2023

New Reimbursement policy: Bundled Supplies and Services - Facility*

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

Reimbursement PoliciesCommercialMay 1, 2023

Reimbursement policy update: Multiple and Bilateral Surgery Processing - Professional*
*Notice of Material Amendment to Contract and/or Change to Prior Authorization Requirements

Products & Programs

Products & ProgramsCommercialMay 1, 2023

Notification about submitting itemized bills*

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

PharmacyCommercialMay 1, 2023

Specialty pharmacy updates - May 2023*

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

State & Federal

State & FederalMedicaid Managed CareMay 1, 2023

You are invited! Connections app webinar

State & FederalMedicaid Managed CareMay 1, 2023

Provider Advisory Council

State & FederalMedicare AdvantageMay 1, 2023

Did your patient have a recent fracture?

State & FederalMedicare AdvantageMay 1, 2023

Genetic testing

OHBCBS-CDCRCM-023180-23

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

* Availity, LLC is an independent company providing administrative support services on behalf of the health plan.

* Carelon Medical Benefits Management, Inc. is an independent company providing utilization management services on behalf of the health plan.