CommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsApril 1, 2024

April 2024 Provider Newsletter

Featured Articles

Education & TrainingCommercialApril 1, 2024

Blue High Performance Network

Administrative

AdministrativeCommercialApril 1, 2024

HCPCS to revenue code alignment for behavioral health

AdministrativeCommercialApril 1, 2024

Review your online provider directory information

AdministrativeCommercialApril 1, 2024

Emergency department protocol for Special Investigation Unit review

Digital SolutionsCommercialMarch 22, 2024

Coming soon — digital-only authorization case status notifications

Digital SolutionsCommercialApril 1, 2024

Home Health Agency Capabilities Survey

Education & Training

Education & TrainingCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsApril 1, 2024

April is National Minority Health Month and Stress Awareness Month

Education & TrainingCommercialMarch 12, 2024

Important reminder: The correct original claim number must be included if submitting a corrected claim

Education & TrainingBadgerCare Plus and Medicaid SSI ProgramsApril 1, 2024

New digital platform for eLearning

Policy Updates

Medical Policy & Clinical GuidelinesBadgerCare Plus and Medicaid SSI ProgramsMarch 18, 2024

Clinical Criteria updates — December 2023

Medical Policy & Clinical GuidelinesCommercialApril 1, 2024

Medical Policies and Clinical Guidelines updates — April 2024

Medical Policy & Clinical GuidelinesMedicare AdvantageMarch 4, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Prior AuthorizationCommercialMarch 27, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs

Prior AuthorizationCommercialMedicare AdvantageMarch 20, 2024

Carelon Medical Benefits Management, Inc. genetic testing code updates

Prior AuthorizationBadgerCare Plus and Medicaid SSI ProgramsApril 1, 2024

Authorizations for DMEPOS services for Medicaid members

Prior AuthorizationMedicare AdvantageMarch 11, 2024

Prior authorization requirement changes effective July 1, 2024

Reimbursement PoliciesCommercialApril 1, 2024

Reimbursement policy update: Virtual Visits — Professional and Facility

Products & Programs

PharmacyMedicare AdvantageMarch 22, 2024

Expansion of specialty pharmacy precertification list

PharmacyBadgerCare Plus and Medicaid SSI ProgramsMarch 6, 2024

Prior authorization updates for medications billed under the medical benefit

Elfabrio, Epkinly, Qalsody, Vyjuvek, and Zynyz

Quality Management

Quality ManagementCommercialMedicare AdvantageMarch 8, 2024

HEDIS® 2024 documentation for Colorectal Cancer Screening (COL-E)

Quality ManagementBadgerCare Plus and Medicaid SSI ProgramsMarch 8, 2024

HEDIS® 2024 documentation for Colorectal Cancer Screening (COL-E)

WIBCBS-CDCRCM-053377-24

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).