CommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsJune 30, 2023

July 2023 Provider Newsletter

Featured Articles

Digital SolutionsCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsJune 30, 2023

Provider data management capability now available on Availity Essentials — retirement of previous intake channels October 1, 2023

Products & ProgramsCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsJune 30, 2023

Advancing health equity: Leveraging data to promote meaningful patient-provider relationships

Administrative

AdministrativeBadgerCare Plus and Medicaid SSI ProgramsJune 30, 2023

Unspecified diagnosis code of site and laterality

AdministrativeCommercialMedicare AdvantageJune 30, 2023

Unspecified diagnosis code of site and laterality

AdministrativeCommercialJune 30, 2023

Notification of NCCI review of medically unlikely edits

AdministrativeCommercialJune 30, 2023

Maintain your online provider directory information

Digital SolutionsCommercialJune 30, 2023

Requests for Additional Information are now digital

Behavioral Health

Behavioral HealthCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsJune 30, 2023

Important information regarding the recent Carelon Behavioral Health, Inc. assignment mailing

Education & Training

Education & TrainingCommercialJune 22, 2023

Newborn authorizations and baby names

Education & TrainingCommercialMedicare AdvantageJune 30, 2023

The BlueCard Provider Manual can answer your questions about the program

WebinarsMedicare AdvantageJune 30, 2023

Required training - Model of Care

Policy Updates

Policy UpdatesBadgerCare Plus and Medicaid SSI ProgramsJune 12, 2023

Clinical Criteria updates for February 2023

Policy UpdatesBadgerCare Plus and Medicaid SSI ProgramsJune 9, 2023

Clinical Criteria updates for December 2022

Medical Policy & Clinical GuidelinesMedicare AdvantageJune 26, 2023

Medical Policies and Clinical Utilization Management Guidelines update for February 2023

Medical Policy & Clinical GuidelinesCommercialJune 22, 2023

Expansion of Carelon Medical Benefits Management, Inc. Cardiology program clinical appropriateness review for Pacemakers program

Prior AuthorizationBadgerCare Plus and Medicaid SSI ProgramsJune 26, 2023

Medical Prior Authorization update Fylnetra, Rolvedon, and Stimufend

Prior AuthorizationBadgerCare Plus and Medicaid SSI ProgramsJune 12, 2023

Carelon MSK - Spine Surgery Code updates effective November 1, 2023

Prior AuthorizationBadgerCare Plus and Medicaid SSI ProgramsMay 31, 2023

Cimerli Medical Prior Authorization update

Prior AuthorizationCommercialJune 30, 2023

Carelon Medical Benefits Management, Inc. genetic testing CPT code list update

Prior AuthorizationMedicare AdvantageJune 6, 2023

Carelon Medical Benefits Management, Inc. genetic testing CPT code list update

Reimbursement PoliciesCommercialJune 30, 2023

New reimbursement policy: Multiple Procedure Payment Reduction - Professional

Reimbursement PoliciesCommercialJune 30, 2023

Reimbursement policy update: Prolonged Services - Professional

Products & Programs

PharmacyMedicare AdvantageJune 26, 2023

Medicare Part B precert expansion may multiple drug alignment

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