Highlights

Key Updates

Administrative Digital SolutionsCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsNovember 1, 2024

Roster Automation updates: roster download functionality

Quality ManagementCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsOctober 25, 2024

Time to prepare for HEDIS medical record review

Education & TrainingBadgerCare Plus and Medicaid SSI ProgramsOctober 23, 2024

Reminder: take action to protect infants from respiratory syncytial virus this season

AdministrativeCommercialOctober 23, 2024

Do you offer telehealth services? Let us know!

Education & TrainingMedicare AdvantageOctober 15, 2024

Model of Care training reminder


What's New

Recent Updates

Products & ProgramsCommercialNovember 21, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs

AdministrativeMedicare AdvantageNovember 18, 2024

Wisconsin 2025 Medicare Advantage plan changes

Products & Programs PharmacyCommercialNovember 18, 2024

Material adverse change

Specialty pharmacy updates — December 2024

Administrative Digital SolutionsMedicare AdvantageNovember 18, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs

Education & TrainingMedicare AdvantageNovember 18, 2024

Notice of change: Part D Rx HCCs

AdministrativeMedicare AdvantageNovember 15, 2024

Skilled nursing facility — vaccine serum compensation

Policy UpdatesBadgerCare Plus and Medicaid SSI ProgramsNovember 15, 2024

Clinical Criteria updates

Effective December 18, 2024

Products & Programs PharmacyMedicare AdvantageNovember 14, 2024

Medicare Part D overhaul: What's new in 2025 for your prescription drug costs?

Policy UpdatesBadgerCare Plus and Medicaid SSI ProgramsNovember 7, 2024

Clinical Criteria updates

Effective December 11, 2024

Administrative Digital SolutionsCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsNovember 1, 2024

Roster Automation updates: roster download functionality

Products & Programs Federal Employee Program (FEP)CommercialNovember 1, 2024

Submit corrected claims electronically for the Federal Employee Program®

AdministrativeCommercialNovember 1, 2024

Personalized Match update

Products & Programs PharmacyMedicare AdvantageNovember 1, 2024

Improving patient outcomes: back to the basics

AdministrativeCommercialNovember 1, 2024

Access to quality care

Administrative Digital SolutionsCommercialNovember 1, 2024

Adopting digital member ID cards

Administrative Digital SolutionsBadgerCare Plus and Medicaid SSI ProgramsNovember 1, 2024

Enhanced personalized match: making the care provider search more informed and personalized

Policy Updates Reimbursement PoliciesCommercialNovember 1, 2024

Material adverse change

Reimbursement policy update: Nurse Practitioner and Physician Assistant Services

Policy UpdatesMedicare AdvantageOctober 30, 2024

Clinical Criteria updates

Effective December 2, 2024

Quality ManagementMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsOctober 29, 2024

HEDIS Measure Tips — Appropriate Treatment for Upper Respiratory Infection (URI) 2025

Quality ManagementCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsOctober 25, 2024

Time to prepare for HEDIS medical record review

Products & Programs PharmacyCommercialOctober 24, 2024

Material adverse change

Specialty pharmacy updates — November 2024

Quality ManagementBadgerCare Plus and Medicaid SSI ProgramsOctober 24, 2024

Provider: CAHPS awareness

Education & TrainingBadgerCare Plus and Medicaid SSI ProgramsOctober 23, 2024

Reminder: take action to protect infants from respiratory syncytial virus this season

Quality Management Optimizing HEDIS & STARSCommercialMedicare AdvantageOctober 23, 2024

HEDIS Measure Tips — Appropriate Testing for Pharyngitis (CWP) 2025

AdministrativeCommercialOctober 23, 2024

Do you offer telehealth services? Let us know!

Quality Management Optimizing HEDIS & STARSCommercialMedicare AdvantageOctober 22, 2024

HEDIS Measure Tips — Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB) 2025

Education & TrainingMedicare AdvantageOctober 15, 2024

Model of Care training reminder

Policy Updates Prior AuthorizationBadgerCare Plus and Medicaid SSI ProgramsOctober 10, 2024

Prior authorization requirement changes

Effective December 1, 2024

Quality ManagementCommercialMedicare AdvantageOctober 7, 2024

HEDIS Measure Tips — Cardiac Rehabilitation (CRE) 2025

Quality Management Optimizing HEDIS & STARSMedicare AdvantageOctober 4, 2024

HEDIS Measure Tips — Adults’ Access to Preventive/Ambulatory Health Services (AAP) 2025

Quality Management Optimizing HEDIS & STARSCommercialMedicare AdvantageOctober 3, 2024

Blood Pressure Control for Patients With Diabetes (BPD) 2025

Policy UpdatesBadgerCare Plus and Medicaid SSI ProgramsOctober 2, 2024

Clarification to Carelon Medical Benefits Management, Inc. updates effective September 1, 2024

Quality ManagementMedicare AdvantageOctober 2, 2024

Pharmacotherapy Management of COPD Exacerbation (PCE) 2025

Policy Updates Reimbursement PoliciesCommercialOctober 1, 2024

Material adverse change

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

Administrative Digital SolutionsMedicare AdvantageOctober 1, 2024

Introducing the Care Provider Recognition Program from Anthem

Policy Updates Reimbursement PoliciesMedicare AdvantageOctober 1, 2024

Clarification to reimbursement policy update: Nurse Practitioner and Physician Assistant Services

Products & Programs PharmacyMedicare AdvantageOctober 1, 2024

Medicare Part D overhaul: What's new in 2025 for your prescription drug costs?

Quality ManagementCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsOctober 1, 2024

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

Policy Updates Reimbursement PoliciesBadgerCare Plus and Medicaid SSI ProgramsOctober 1, 2024

Clarification to reimbursement policy update: Nurse Practitioner and Physician Assistant Services

Quality ManagementCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsOctober 1, 2024

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

Products & Programs PharmacyCommercialOctober 1, 2024

Pharmacy information available on our provider website

AdministrativeCommercialOctober 1, 2024

National Accounts 2025 precertification list

AdministrativeCommercialOctober 1, 2024

Updated provider manual — November 1, 2024