Anthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsApril 1, 2025

April 2025 Provider Newsletter

Featured Articles

AdministrativeAnthem Blue Cross and Blue Shield | Medicare AdvantageJanuary 1, 2025

D‑SNP members can earn rewards by participating in select healthcare activities

Prior AuthorizationAnthem Blue Cross and Blue Shield | CommercialMarch 28, 2025

Streamline your workflow: Submit BH authorizations through Availity Essentials

PharmacyHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMarch 3, 2025

Important information about specialty prescriptions

Effective March 1, 2025

PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageFebruary 28, 2025

Important change to your patients’ specialty prescriptions

Effective April 1, 2025


Administrative

Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsFebruary 28, 2025

Availity launches enhanced provider enrollment features for improved efficiency

Education & Training

Education & TrainingAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsApril 1, 2025

Register for our next webinar: Enhancing Diabetes Management — Focus on Standardized Metrics

Education & TrainingAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsJanuary 1, 2025

Enhance billing and coding accuracy with new Payment Integrity training

Education & TrainingAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsFebruary 28, 2025

Resources to support diverse patients and communities

Guideline Updates

Guideline UpdatesHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsFebruary 26, 2025

Clinical Criteria updates

Effective March 28, 2025

Guideline UpdatesAnthem Blue Cross and Blue Shield | Medicare AdvantageFebruary 27, 2025

Clinical Criteria updates

Effective March 28, 2025

Guideline UpdatesHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMarch 24, 2025

Carelon Medical Benefits Management, Inc. updates

Effective on May 1, 2025

Coverage and Clinical GuidelinesAnthem Blue Cross and Blue Shield | Medicare AdvantageMarch 11, 2025

Medical Policies and Clinical Utilization Management Guidelines update

Effective April 12, 2025

Prior AuthorizationAnthem Blue Cross and Blue Shield | Medicare AdvantageMarch 27, 2025

Outpatient preapproval update from Carelon Medical Benefits Management, Inc.

Prior AuthorizationAnthem Blue Cross and Blue Shield | Medicare AdvantageMarch 26, 2025

Prior authorization requirement changes

Effective July 1, 2025

Prior AuthorizationAnthem Blue Cross and Blue Shield | Medicare AdvantageMarch 6, 2025

Prior authorization requirement changes
Effective July 1, 2025

Products & Programs

PharmacyAnthem Blue Cross and Blue Shield | CommercialMarch 27, 2025

Specialty pharmacy updates — April 2025

PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageMarch 19, 2025

Medicare Part B preapproval expands with new drug additions

PharmacyHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMarch 31, 2025

Virginia's Medical Preferred Drug List (PDL)/ Common Core Formulary

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