CommercialMedicare AdvantageMedicaid Managed CareMay 1, 2024
May 2024 Provider Newsletter
Featured Articles
CommercialMedicare AdvantageMedicaid Managed CareMay 1, 2024
Digital Request for Additional Information is now available for all lines of business
Medicare AdvantageApril 5, 2024
CarelonRx, Inc. Mail changed to CarelonRx Pharmacy on January 1, 2024
Administrative
CommercialMedicare AdvantageMay 1, 2024
Carelon Post Acute Solutions, LLC will begin operating as Carelon Medical Benefits Management, Inc.CommercialMay 1, 2024
CAA: Maintain your online provider directory informationCommercialMay 1, 2024
Inaccurate laterality and diagnosis combinationMedicare AdvantageMedicaid Managed CareMay 1, 2024
Inaccurate laterality and diagnosis combinationCommercialApril 24, 2024
Notice of readmission processing changeMedicaid Managed CareMay 1, 2024
Behind the scenes, get to know: Janene JacobsMedicaid Managed CareJanuary 1, 2024
New resources available for ePRAFCommercialMay 1, 2024
Provider manual updates to become effective August 1, 2024Medicare AdvantageMedicaid Managed CareApril 26, 2024
Introducing new functionality for non-medical providersCommercialMedicare AdvantageMedicaid Managed CareApril 15, 2024
Coming soon — Submit behavioral health authorizations through the Authorization application on AvailityCommercialApril 23, 2024
Overview of the Preference Center on Availity EssentialsCommercialMedicare AdvantageMay 1, 2024
Roster automation updateMedicare AdvantageMay 1, 2024
Personalized Match updateEducation & Training
CommercialApril 25, 2024
Instructions for donor claim billingCommercialMedicare AdvantageMedicaid Managed CareMay 1, 2024
Rotary to ground educational messageMedicaid Managed CareMarch 31, 2023
Ready, set, renew!Medicaid Managed CareApril 1, 2024
You are invited: Behavioral health provider orientationMedicaid Managed CareApril 1, 2024
You are invited: General provider orientationPolicy Updates
Medicaid Managed CareApril 2, 2024
Clinical Criteria updates — August 2023Medicaid Managed CareMarch 25, 2024
Clinical Criteria updates — November 2023Medicaid Managed CareApril 2, 2024
Clinical Criteria updates — December 2023Medicaid Managed CareApril 4, 2024
Carelon Medical Benefits Management, Inc. updatesMedicaid Managed CareApril 22, 2024
Medical Policies and Clinical Utilization Management Guidelines updateMedicaid Managed CareApril 10, 2024
CPT Category II Code Additional Reimbursements for Ohio Medicaid Managed CareMedicaid Managed CareMay 1, 2024
New lab testing Clinical GuidelinesProducts & Programs
CommercialMay 1, 2024
HEDIS tips: Adult Immunization Status (AIS-E)Medicaid Managed CareApril 16, 2024
Prior authorization updates for medications billed under the medical benefitColumvi, Izervay, Rystiggo, Vyvgart Hytrulo, and Eylea HD
CommercialApril 24, 2024
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Specialty pharmacy updates — May 2024CommercialMay 1, 2024
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Designated specialty pharmacy network updatesCommercialMarch 1, 2024
Pharmacy information available on our provider websiteCommercialApril 9, 2024
Acquisition of Paragon HealthcareMedicare AdvantageApril 8, 2024
Anthem expands specialty pharmacy precertification listQuality Management
CommercialMedicaid Managed CareMay 1, 2024
Take action to improve adolescent immunizations ratesOHBCBS-CDCRCM-056146-24
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