May 1, 2025

May 2025 Provider Newsletter

Filter By: AllAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid products

Featured Articles

AdministrativeAnthem Blue Cross and Blue Shield | CommercialMay 1, 2025

Wellness visits may increase appointment scheduling For members enrolled in an ACA plan


Administrative

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

Additional drug codes added to medical claims edit system

AdministrativeHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsApril 29, 2025

Important guidelines for avoiding common billing errors in DME claims

Behavioral Health

Behavioral HealthHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 1, 2025

FDA lifts risk evaluation and mitigation strategy reporting requirements for Clozapine

Education & Training

Education & TrainingHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMay 1, 2025

Enhancing your learning experience: latest updates in Provider Pathways

Education & TrainingAnthem Blue Cross and Blue Shield | CommercialMay 1, 2025

Streamline your prior authorizations with our digital tools

Education & TrainingAnthem Blue Cross and Blue Shield | CommercialMay 1, 2025

Free CE training: Lifestyle Medicine & Food as Medicine Essentials Course

Guideline Updates

Guideline UpdatesHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsApril 3, 2025

Clinical Criteria updates

Effective May 7, 2025

Guideline UpdatesAnthem Blue Cross and Blue Shield | CommercialMay 1, 2025

Clinical Criteria updates for specialty pharmacy are available

Effective August 1, 2025

Coverage and Clinical GuidelinesHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsApril 1, 2025

Medical Policies and Clinical Utilization Management Guidelines update

Effective May 1, 2025

Coverage and Clinical GuidelinesAnthem Blue Cross and Blue Shield | Medicare AdvantageApril 24, 2025

Medical Policies and Clinical Utilization Management Guidelines update

Effective May 25, 2025

Coverage and Clinical GuidelinesAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageApril 30, 2025

Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness Guidelines

Effective August 1, 2025

Coverage and Clinical GuidelinesAnthem Blue Cross and Blue Shield | CommercialMay 1, 2025

Coverage and Clinical Guidelines update August 1, 2025

Prior AuthorizationHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsApril 11, 2025

Prior authorization requirement changes

Effective June 1, 2025
Codes: J9248 and L5841

Products & Programs

PharmacyHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsApril 29, 2025

New preapproval rules for medications

Effective June 1, 2025
Ebglyss, Lymphir, Niktimvo, and Ocrevus Zunovoa

PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageApril 18, 2025

New specialty pharmacy medical step therapy requirement

Effective June 1, 2025
Hercessi

PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageApril 18, 2025

Specialty pharmacy preapproval list update

Effective August 1, 2025
Jubbonti; Wyost


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