CommercialMedicare AdvantageMedicaid Managed CareNovember 1, 2023
November 2023 Provider Newsletter
Featured Articles
CommercialOctober 31, 2023
Digital RFAI process improvements
CommercialOctober 31, 2023
Practitioners’ rights during credentialing process
Administrative
Medicare AdvantageNovember 1, 2023
Updates to correct coding editingMedicare AdvantageOctober 31, 2023
2024 Medicare Advantage service area and benefit updatesMedicare AdvantageNovember 1, 2023
Usage of liability modifiersMedicaid Managed CareOctober 31, 2023
Billing for durable medical equipmentCommercialNovember 1, 2023
CAA: Maintain your online provider directory informationCommercialNovember 1, 2023
Filing digital claims disputes: Transparent and trackableEducation & Training
Medicaid Managed CareOctober 18, 2023
Applied behavior analysis servicesMedicaid Managed CareOctober 31, 2023
Medicaid provider orientationsPolicy Updates
Medicaid Managed CareOctober 10, 2023
RETRACTION: Notice of Material Amendment: Clinical coding changes effective February 1, 2024CommercialNovember 1, 2023
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Medical Policies and Clinical Guidelines updates — November 2023Medicare AdvantageNovember 1, 2023
Carelon Medical Benefits Management, Inc. updates — November 2023Medicare AdvantageOctober 19, 2023
Expansion of Carelon Medical Benefits Management, Inc. programsMedicaid Managed CareOctober 24, 2023
Prior authorization update - Lamzede, Lunsumio, Rebyota, etc.Medicare AdvantageOctober 16, 2023
RETRACTION: Prior authorization requirement changes effective February 1, 2024Codes 32274 and 32275
Medicare AdvantageOctober 3, 2023
Prior authorization requirement changes effective February 1, 2024 - code J1411CommercialSeptember 28, 2023
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Expansion of Carelon Medical Benefits Management, Inc. programs, effective April 1, 2024CommercialOctober 31, 2023
Reimbursement policy update: Pharmaceutical Waste – Professional and FacilityProducts & Programs
CommercialNovember 1, 2023
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Federal Employee Program specialty pharmacy prior authorization reviewCommercialNovember 1, 2023
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
FEP® Specialty Pharmacy prior authorization listCommercialNovember 1, 2023
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Specialty pharmacy updatesCommercialNovember 1, 2023
Pharmacy information available on our provider websiteQuality Management
Medicare AdvantageNovember 1, 2023
Controlling high blood pressure and HEDISMedicaid Managed CareOctober 31, 2023
Controlling high blood pressure and HEDISMedicaid Managed CareOctober 25, 2023
HEDIS measurement year 2023 documentation for Childhood Immunization Status (CIS)CommercialMedicare AdvantageOctober 25, 2023
HEDIS measurement year 2023 documentation for Childhood Immunization Status (CIS)CommercialMedicare AdvantageOctober 15, 2023
HEDIS medical record submission made easier with our Remote EMR Access ServiceMedicaid Managed CareOctober 15, 2023
HEDIS medical record submission made easier with our Remote EMR Access ServiceMedicaid Managed CareOctober 31, 2023
Healthy blood pressure recheck initiativeMedicaid Managed CareOctober 31, 2023
HEDIS measurement year 2023 documentation for Transitions of Care (TRC)CommercialMedicare AdvantageNovember 1, 2023
HEDIS measurement year 2023 documentation for Transitions of Care (TRC)CommercialMedicare AdvantageSeptember 27, 2023
Be Antibiotics Aware: Protect your patientsMedicare AdvantageNovember 1, 2023
Statin therapy end of year best practicesOHBCBS-CDCRCM-041576-23
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