CommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsJune 1, 2024

June 2024 Provider Newsletter

Administrative

AdministrativeCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsJune 1, 2024

Availity Essentials single claim submission response reports

AdministrativeCommercialJune 1, 2024

Implant — Facility Editing update

AdministrativeCommercialJune 1, 2024

CAA: Review your online provider directory information

AdministrativeCommercialJune 1, 2024

Updated 2024 Provider Manual now available

Digital SolutionsCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsMay 23, 2024

Digital RFAI Availity training

Digital SolutionsMedicare AdvantageApril 17, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs

Education & Training

Education & TrainingBadgerCare Plus and Medicaid SSI ProgramsJune 1, 2024

Hepatitis C case management program

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

June is LGBTQIA+ Pride Month

Education & TrainingCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsMay 23, 2024

You are invited: Thriving, not just surviving: navigating challenging times as a clinician

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

Introducing advanced eLearning features for MyDiversePatients.com

Policy Updates

Medical Policy & Clinical GuidelinesCommercialMay 22, 2024

Medical Policies and Clinical Guidelines updates – June 2024

Medical Policy & Clinical GuidelinesBadgerCare Plus and Medicaid SSI ProgramsMay 15, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Medical Policy & Clinical GuidelinesCommercialApril 30, 2024

MCG Care Guidelines 28th edition

Medical Policy & Clinical GuidelinesBadgerCare Plus and Medicaid SSI ProgramsMay 20, 2024

MCG Care Guidelines 28th edition

Medical Policy & Clinical GuidelinesMedicare AdvantageMay 1, 2024

MCG Care Guidelines 28th edition

Medical Policy & Clinical GuidelinesMedicare AdvantageMay 7, 2024

Clinical Criteria updates

Effective June 10, 2024

Medical Policy & Clinical GuidelinesCommercialMay 28, 2024

Updates to Carelon Post-Acute Care Clinical Appropriateness Guidelines

Medical Policy & Clinical GuidelinesCommercialMedicare AdvantageMay 3, 2024

Carelon Medical Benefits Management, Inc. genetic testing code updates

Prior AuthorizationCommercialJune 1, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs

Products & Programs

PharmacyMedicare AdvantageJune 1, 2024

Addressing medication adherence gaps

PharmacyMedicare AdvantageJune 1, 2024

Improving patient outcomes with statin therapy in diabetes

PharmacyCommercialJune 1, 2024

Pharmacy information available on our provider website

PharmacyBadgerCare Plus and Medicaid SSI ProgramsMay 6, 2024

Prior authorization updates for medications billed under the medical benefit

Quality Management

Quality ManagementBadgerCare Plus and Medicaid SSI ProgramsJune 1, 2024

Complex Case Management program

Quality ManagementBadgerCare Plus and Medicaid SSI ProgramsJune 1, 2024

Important information about utilization management

Quality ManagementBadgerCare Plus and Medicaid SSI ProgramsJune 1, 2024

Member Rights and Responsibilities Statement

Quality ManagementCommercialMay 6, 2024

Enhance patient access to digital health resources

Quality ManagementCommercialApril 19, 2024

Improving patient health and digital literacies

Quality ManagementCommercialBadgerCare Plus and Medicaid SSI ProgramsMay 15, 2024

Tips to Improve Adolescent Immunization (IMA) Rates

Quality ManagementCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsJune 1, 2024

New resources to improve your HEDIS® and CAHPS® quality rates

Quality ManagementCommercialMedicare AdvantageApril 22, 2024

Statin Use in Persons with Cardiovascular Disease (SPC) measure exclusion criteria: HEDIS® 2024 measurement year

WIBCBS-CDCRCM-059395-24

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