CommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsAugust 1, 2023

August 2023 Provider Newsletter

Featured Articles

Education & TrainingCommercialMedicare AdvantageAugust 1, 2023

Looking to earn CME credits? Check out the CME Engagement Hub!

Digital SolutionsCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsAugust 1, 2023

Reminder: Start using the Provider Data Management application now on Availity Essentials — retirement of previous intake channels October 1, 2023


Administrative

AdministrativeMedicare AdvantageJuly 18, 2023

Urinary tract infection tool kits are on the way

AdministrativeBadgerCare Plus and Medicaid SSI ProgramsAugust 1, 2023

Clinical Laboratory Improvement Amendments

AdministrativeCommercialMedicare AdvantageAugust 1, 2023

Clinical Laboratory Improvement Amendments

AdministrativeCommercialAugust 1, 2023

Updated provider manual available September 1, 2023

AdministrativeCommercialAugust 1, 2023

Federal Consolidated Appropriations Act (CAA) Gag Clause

AdministrativeCommercialAugust 1, 2023

CAA: Review your online provider directory information regularly

AdministrativeBadgerCare Plus and Medicaid SSI ProgramsJune 30, 2023

Updates to the Anthem BadgerCare Plus and Medicaid SSI provider manual for Wisconsin

Policy Updates

Policy UpdatesBadgerCare Plus and Medicaid SSI ProgramsJuly 21, 2023

Clinical Criteria Updates - March 2023

Policy UpdatesMedicare AdvantageJune 29, 2023

Clinical Criteria updates - March 2023

Medical Policy & Clinical GuidelinesBadgerCare Plus and Medicaid SSI ProgramsJuly 5, 2023

Medical Policies and Clinical Utilization Management Guidelines Update (February 2023)

Medical Policy & Clinical GuidelinesBadgerCare Plus and Medicaid SSI ProgramsJune 22, 2023

Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness Guidelines for joint surgery and MSK level of care

Prior AuthorizationMedicare AdvantageJuly 25, 2023

Prior authorization requirement changes effective November 1, 2023

Prior AuthorizationBadgerCare Plus and Medicaid SSI ProgramsAugust 1, 2023

Fylnetra, Stimufend, and Rolvedon Medical Step Therapy Notice

Reimbursement PoliciesBadgerCare Plus and Medicaid SSI ProgramsAugust 1, 2023

Technology Assisted Surgical Procedures

Reimbursement PoliciesMedicare AdvantageAugust 1, 2023

Technology Assisted Surgical Procedures

Products & Programs

PharmacyCommercialAugust 1, 2023

Specialty pharmacy updates - August 2023

PharmacyCommercialAugust 1, 2023

Specialty pharmacy updates - August 2023

PharmacyCommercialAugust 1, 2023

Pharmacy information available on our provider website

PharmacyMedicare AdvantageAugust 1, 2023

Medication adherence: Back to the basics

PharmacyMedicare AdvantageAugust 1, 2023

Why statin therapy is important in your patients with diabetes

Quality Management

Quality ManagementMedicare AdvantageAugust 1, 2023

Healthy blood pressure recheck initiative

Quality ManagementMedicare AdvantageAugust 1, 2023

Healthy blood pressure recheck initiative

Quality ManagementBadgerCare Plus and Medicaid SSI ProgramsAugust 1, 2023

Congenital syphilis is a sentinel health event

Quality ManagementCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsJuly 17, 2023

Pharmacotherapy Management of COPD Exacerbation (PCE) HEDIS® Measure

WIBCBS-CDCRCM-030310-23


HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
Carelon Medical Benefits Management, Inc. is an independent company providing utilization management services on behalf of the health plan.Availity, LLC is an independent company providing administrative support services on behalf of the health plan.