CommercialMedicare AdvantageMedicaid Managed CareOctober 1, 2024

October 2024 Provider Newsletter

Featured Articles

Digital SolutionsCommercialMedicare AdvantageSeptember 12, 2024

Roster Automation updates effective November 15, 2024: enhanced reporting to increase data accuracy

Digital SolutionsMedicare AdvantageOctober 1, 2024

Introducing the Care Provider Recognition Program from Anthem

Prior AuthorizationMedicare AdvantageSeptember 6, 2024

Changes to special supplemental benefits for the chronically ill eligibility requirements

AdministrativeMedicaid Managed CareOctober 1, 2024

Provider revalidations


Administrative

AdministrativeMedicaid Managed CareSeptember 18, 2024

Doula contracting for Medicaid in Ohio: FAQ

AdministrativeMedicaid Managed CareJanuary 1, 2024

New resources available for ePRAF

AdministrativeMedicaid Managed CareAugust 1, 2024

Access instant health plan information via Availity Essentials

AdministrativeCommercialOctober 1, 2024

National Accounts 2025 precertification list

Digital SolutionsMedicare AdvantageMedicaid Managed CareSeptember 18, 2024

Expansion of digital-only authorization case status notifications

Digital SolutionsCommercialMedicare AdvantageMedicaid Managed CareSeptember 4, 2024

Digital Provider Enrollment now available for additional provider types in Availity Essentials

Education & Training

Education & TrainingMedicare AdvantageSeptember 16, 2024

Seamless advance care: MyDirectives digital tool for D-SNP members

Education & TrainingMedicaid Managed CareOctober 1, 2024

Join our Provider Advisory Council

WebinarsMedicaid Managed CareSeptember 1, 2024

You are invited: Skilled nursing facility webinar

WebinarsMedicaid Managed CareOctober 1, 2024

You are invited: Behavioral Health orientation

WebinarsMedicaid Managed CareOctober 1, 2024

You are invited: Hospice education webinar

WebinarsMedicaid Managed CareOctober 1, 2024

You are invited: General provider orientation

Policy Updates

Policy UpdatesMedicare AdvantageSeptember 3, 2024

Clinical Criteria updates

Effective October 4, 2024

Policy UpdatesMedicaid Managed CareSeptember 3, 2024

Clinical Criteria updates

Effective October 6, 2024

Policy UpdatesMedicaid Managed CareSeptember 4, 2024

Clinical Criteria updates

Effective October 6, 2024

Medical Policy & Clinical GuidelinesMedicare AdvantageSeptember 10, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Effective October 10, 2024

Medical Policy & Clinical GuidelinesMedicaid Managed CareSeptember 19, 2024

Medical Policies and Clinical Utilization Management Guidelines Update

Effective October 20, 2024

Prior AuthorizationMedicare AdvantageSeptember 23, 2024

Prior authorization requirement changes

Effective January 1, 2025

Reimbursement PoliciesCommercialOctober 1, 2024

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

Reimbursement policy update: Modifiers 59 and XE, XP, XS, and XU: Distinct Procedural Service — Professional

Products & Programs

PharmacyCommercialSeptember 16, 2024

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

Specialty pharmacy updates — October 2024

PharmacyCommercialOctober 1, 2024

Pharmacy information available on our provider website

Quality Management

Quality ManagementCommercialMedicare AdvantageMedicaid Managed CareOctober 1, 2024

Prevent flu and COVID-19: drive the change through vaccination

Quality ManagementCommercialMedicare AdvantageMedicaid Managed CareOctober 1, 2024

HEDIS medical record submission made easier with our Remote EMR Access service

OHBCBS-CDCRCM-067882-24

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