September 1, 2023
September 2023 Provider Newsletter
Filter By: AllCommercialMedicare AdvantageMedicaid Managed Care
Featured Articles
CommercialSeptember 1, 2023
HCPCS to revenue code alignment
CommercialMedicaid Managed CareJuly 27, 2023
Help your patients continue their care and navigate Medicaid renewal
Medicare AdvantageSeptember 1, 2023
Reminder: Review the health reimbursement arrangement and care plan updates in Availity Essentials
Administrative
CommercialSeptember 1, 2023
Update — Enhanced outpatient facility editing for National Correct Coding InitiativeCommercialSeptember 1, 2023
Support documentation for Carelon Medical Benefits Management, Inc. prior authorization requestsCommercialSeptember 1, 2023
CAA: Have you reviewed your online provider directory information lately?Medicaid Managed CareSeptember 1, 2023
Provider Orientation dates - Summer 2023CommercialSeptember 1, 2023
Consider a FIT kit for your patients aged 45 and older at average risk for colon cancerCommercialSeptember 1, 2023
Improvements to Digital RFAI Attachment filtering and reportingCommercialSeptember 1, 2023
Simplifying claims attachments: Digital Request for Additional Information through Availity.comMedicare AdvantageSeptember 1, 2023
Personalized match phase 1: Specialist provider overviewMedicaid Managed CareSeptember 1, 2023
Submitting prior authorizations is getting easierCommercialSeptember 1, 2023
Member search feature enhancement: Search for a patient without using member ID in Availity EssentialsEducation & Training
Medicaid Managed CareSeptember 1, 2023
You're invited: Psych Hub’s Mental Health Practitioner Hub webinarsCommercialMedicare AdvantageMedicaid Managed CareJuly 7, 2023
You're invited: Thriving, not just surviving: Youth mental health in today's worldMedicaid Managed CareSeptember 1, 2023
Medicaid provider orientationsPolicy Updates
Medicare AdvantageAugust 14, 2023
Clinical Criteria updates - May 2023CommercialSeptember 1, 2023
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Medical policies and clinical guidelines updates - September 2023CommercialSeptember 1, 2023
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Medical policies and clinical guidelines updatesCommercialSeptember 1, 2023
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Medical policies and clinical guidelines moving to pre-certMedicaid Managed CareAugust 9, 2023
Prior authorization requirement changes effective October 1, 2023CommercialMedicare AdvantageJune 9, 2023
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Carelon Medical Benefits Management, Inc. advanced imaging — Imaging of the brain CPT code list updateMedicare AdvantageSeptember 1, 2023
Nonemergent ambulance transportation in OhioMedicare AdvantageAugust 7, 2023
Prior authorization requirement changes effective December 1, 2023CommercialSeptember 1, 2023
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Reimbursement policy update: Documentation Standards for Episodes of Care — ProfessionalCommercialSeptember 1, 2023
Reimbursement policy update: Documentation and Reporting Guidelines for Evaluation and Management Services - ProfessionalCommercialSeptember 1, 2023
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Reimbursement policy update: Place of Service – FacilityCommercialSeptember 1, 2023
Clarification to reimbursement policy update: Prolonged Services – ProfessionalCommercialSeptember 1, 2023
New reimbursement policy: Split Care Surgical Modifiers — ProfessionalProducts & Programs
CommercialSeptember 1, 2023
Sublocade® updateCommercialSeptember 1, 2023
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Specialty pharmacy updates – September 2023Medicare AdvantageAugust 3, 2023
Specialty pharmacy medical step therapy for hyaluronan injectionsMedicare AdvantageJuly 28, 2023
UPDATED: Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification listMedicaid Managed CareAugust 2, 2023
PA update - AltuviiioQuality Management
Medicare AdvantageSeptember 1, 2023
Medication reconciliation post inpatient dischargeOHBCBS-CDCRCM-035548-23
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