CommercialMedicare AdvantageMedicaid Managed CareNovember 1, 2024

November 2024 Provider Newsletter

Featured Articles

Quality ManagementCommercialMedicare AdvantageMedicaid Managed CareOctober 25, 2024

Time to prepare for HEDIS medical record review

Education & TrainingMedicaid Managed CareOctober 23, 2024

Reminder: take action to protect infants from respiratory syncytial virus this season

AdministrativeCommercialOctober 23, 2024

Do you offer telehealth services? Let us know!

AdministrativeMedicaid Managed CareOctober 23, 2024

Provider data accuracy

Digital SolutionsCommercialOctober 21, 2024

Notification of authorization fax number changes

Education & TrainingMedicare AdvantageOctober 15, 2024

Model of Care training reminder

AdministrativeMedicaid Managed CareSeptember 1, 2024

Provider revalidations


Administrative

AdministrativeMedicaid Managed CareOctober 15, 2024

Updated guidance for Immunizations Covered by Vaccines for Children

AdministrativeMedicaid Managed CareNovember 1, 2024

Behind the scenes, get to know: Patrick Stone

AdministrativeMedicaid Managed CareJanuary 1, 2024

New resources available for ePRAF

AdministrativeCommercialNovember 1, 2024

Personalized Match update

Digital SolutionsCommercialNovember 1, 2024

Adopting digital member ID cards

Behavioral Health

Behavioral HealthCommercialNovember 1, 2024

Introducing a new Applied Behavior Analysis Provider Resource Guide

Education & Training

Education & TrainingMedicaid Managed CareSeptember 1, 2024

Join our Provider Advisory Council

Education & TrainingMedicaid Managed CareNovember 1, 2024

You are invited: Hospice education webinar

Education & TrainingMedicaid Managed CareNovember 1, 2024

You are invited: Behavioral health provider orientation

Education & TrainingMedicaid Managed CareNovember 1, 2024

You are invited: Provider orientation

Policy Updates

Policy UpdatesMedicare AdvantageSeptember 25, 2024

Carelon Medical Benefits Management, Inc. updates

Effective October 26, 2024

Policy UpdatesMedicaid Managed CareSeptember 30, 2024

Carelon Medical Benefits Management, Inc Updates

Effective November 30, 2024

Medical Policy & Clinical GuidelinesMedicaid Managed CareOctober 22, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Effective December 1, 2024

Medical Policy & Clinical GuidelinesMedicaid Managed CareSeptember 30, 2024

Medical Policies and Clinical Utilization Management Guidelines Update

Effective November 30, 2024

Prior AuthorizationMedicaid Managed CareOctober 9, 2024

Prior authorization requirement changes

Effective December 1, 2024

Prior AuthorizationMedicaid Managed CareOctober 10, 2024

Prior authorization requirement changes

Effective December 1, 2024

Prior AuthorizationMedicare AdvantageSeptember 24, 2024

Prior authorization requirement changes

Effective February 1, 2025

Reimbursement PoliciesCommercialNovember 1, 2024

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

Reimbursement policy update: Nurse Practitioner and Physician Assistant Services

Reimbursement PoliciesCommercialNovember 1, 2024

Reimbursement policy reminder: Multiple Surgery — Facility

Products & Programs

Federal Employee Program (FEP)CommercialNovember 1, 2024

Submit corrected claims electronically for the Federal Employee Program®

PharmacyCommercialJuly 1, 2024

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

Correction: Specialty pharmacy updates — July 2024

PharmacyCommercialOctober 24, 2024

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

Specialty pharmacy updates — November 2024

PharmacyMedicare AdvantageNovember 1, 2024

Improving patient outcomes: back to the basics

Quality Management

Quality ManagementMedicaid Managed CareOctober 24, 2024

Provider: CAHPS awareness

OHBCBS-CDCRCM-070465-24

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