Key Updates
CommercialMedicare AdvantageMedicaid Managed CareJuly 1, 2025
Benefits of utilization management attestations: a guide for care providers
Recent Updates
CommercialMedicare AdvantageJuly 18, 2025
New mandatory fields in roster templateCommercialMedicare AdvantageMedicaid Managed CareJuly 1, 2025
Benefits of utilization management attestations: a guide for care providersCommercialJuly 1, 2025
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
New reimbursement policy: Code and Clinical Editing Guidelines — Professional and FacilityMedicare AdvantageJuly 1, 2025
Implementation of chargemaster‑based claims edit for ER levelingCommercialJuly 1, 2025
A quick guide to understanding JW and JZ modifiersMedicare AdvantageJuly 1, 2025
A quick guide to understanding JW and JZ modifiersCommercialMedicare AdvantageMedicaid Managed CareJuly 1, 2025
Seamless Provider Enrollment and Network Management through Availity Essentials optimizes the care provider experienceCommercialJuly 1, 2025
Reimbursement policy update: Nurse Practitioner and Physician Assistant servicesCommercialJuly 1, 2025
Enroll with Availity to verify your provider dataMedicaid Managed CareJuly 1, 2025
Reimbursement Policy Update: Multiple Radiology Payment ReductionMedicaid Managed CareJuly 1, 2025
You are invited: Provider Engagement Council meetingCommercialJuly 1, 2025
View your Fee Schedule in Availity Essentials Payer SpacesCommercialJuly 1, 2025
Update: essential ICD‑10‑CM compliance for outpatient facility claimsCommercialMedicare AdvantageMedicaid Managed CareJuly 1, 2025
Streamlining behavioral health authorizations via Availity EssentialsMedicare AdvantageJuly 1, 2025
Combat diabetes: Close the statin therapy gap for better heart healthCommercialMedicare AdvantageMedicaid Managed CareJuly 1, 2025
Join the 2025 Clinical Quality in Practice webinar seriesCommercialMedicare AdvantageMedicaid Managed CareJuly 1, 2025
National Drug Codes (NDCs) are required for professional and outpatient claimsMedicare AdvantageJune 27, 2025
Specialty pharmacy precertification list expandedEffective November 1, 2025
Axtle, Bizengri, and Bynfezia pen
CommercialJune 25, 2025
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Medical Policies and Clinical Guidelines updates — August 2025Medicare AdvantageJune 23, 2025
Essential information for providers: understanding Medicare Advantage group retiree plansMedicare AdvantageJune 17, 2025
Specialty pharmacy precertification list expansion — key updatesCommercialJune 13, 2025
Streamlined claim submission process updateMedicaid Managed CareJune 11, 2025
Doula claim submission FAQMedicaid Managed CareJune 9, 2025
Precertification/prior authorization requirement changesEffective August 1, 2025
CommercialMedicare AdvantageJune 6, 2025
National Drug Codes (NDCs) are required for outpatient claimsMedicare AdvantageJune 3, 2025
Precertification/prior authorization requirement changesEffective November 1, 2025
Medicaid Managed CareJune 3, 2025
Attention Ohio Medicaid DoulasCommercialJune 2, 2025
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Specialty pharmacy updates: June 2025CommercialJune 1, 2025
Upcoming changes to the provider manual effective September 2025CommercialJune 1, 2025
Update to claims system for global surgical procedures for professional providersMedicaid Managed CareJune 1, 2025
How care providers can support members in challenging timesMedicaid Managed CareJune 1, 2025
Your patients' healthcare journey: understanding their rights and responsibilitiesMedicaid Managed CareJune 1, 2025
Insights on utilization managementCommercialJune 1, 2025
Notice of Material Amendments to Contract and/or Change to Prior Authorization Requirements
Update to Chargemaster Audit ProcessMedicare AdvantageJune 1, 2025
Bridging the gap: enhancing medication adherence for better health outcomesCommercialMedicare AdvantageMedicaid Managed CareJune 1, 2025
Submitting BH authorizations in Availity EssentialsCommercialMedicare AdvantageMedicaid Managed CareJune 1, 2025
Registration is now available for our upcoming CME webinar on Integrating Cancer CareMedicare AdvantageJune 1, 2025
Claims guidance: updating inpatient and outpatient bill typesCommercialJune 1, 2025
Availity Essentials Provider Overpayments application launchCommercialJune 1, 2025
Unlock updated pharmacy insights today — visit our provider websiteCommercialMedicare AdvantageJune 1, 2025
LabCorp and Quest Diagnostics are in-network — reminderCommercialMay 30, 2025
Key updates to the Designated Medical Specialty Pharmacy Drug ListEffective August 1, 2025
Blincyto
Medicaid Managed CareMay 27, 2025
You are invited: care provider coding educationMedicare AdvantageMay 27, 2025
Learn about annual Model of Care training for special needs plansCommercialMedicare AdvantageMay 27, 2025
Boost your roster submission skills with Availity EssentialsCommercialMay 22, 2025
Action required: annual patient safety attestationMedicare AdvantageMay 22, 2025
New specialty pharmacy medical step therapy requirementsEffective July 1, 2025
Pavblu, Ahzantive, Enzeevu, Opuviz, and Yesafili
Medicaid Managed CareMay 21, 2025
Medical Policies and Clinical Utilization Management Guidelines updateEffective June 25, 2025
Medicaid Managed CareMay 20, 2025
Prior authorization updates for medications billed under the medical benefitEffective July 1, 2025
Tevimbra and Tyenne