CommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsMarch 1, 2024

March 2024 Provider Newsletter

Administrative

AdministrativeMedicare AdvantageMarch 1, 2024

CAA: Maintain your online provider directory information

Digital SolutionsMedicare AdvantageFebruary 29, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs effective April 1, 2024

Digital SolutionsCommercialMarch 1, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs

Digital SolutionsCommercialFebruary 21, 2024

Beginning February 2024, you can submit Physical Health prior authorizations through the Authorization application on Availity.com

Education & Training

Education & TrainingCommercialBadgerCare Plus and Medicaid SSI ProgramsMarch 1, 2024

Congenital syphilis intervention opportunities for neonatal and pediatric providers

Education & TrainingBadgerCare Plus and Medicaid SSI ProgramsMarch 1, 2024

Resources to support your diverse patient panel

Policy Updates

Medical Policy & Clinical GuidelinesBadgerCare Plus and Medicaid SSI ProgramsFebruary 21, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Medical Policy & Clinical GuidelinesMedicare AdvantageFebruary 20, 2024

Clinical Criteria updates — December 2023

Medical Policy & Clinical GuidelinesMedicare AdvantageMarch 1, 2024

Carelon Medical Benefits Management, Inc. genetic testing code updates

Prior AuthorizationBadgerCare Plus and Medicaid SSI ProgramsFebruary 16, 2024

Prior authorization requirement changes effective May 1, 2024

Code 64505

Prior AuthorizationMedicare AdvantageJanuary 24, 2024

Prior authorization requirement changes effective May 1, 2024

Code C1825

Prior AuthorizationMedicare AdvantageFebruary 1, 2024

Prior authorization requirement changes effective May 1, 2024

Codes G0481 - G0483

Reimbursement PoliciesCommercialMarch 1, 2024

Reimbursement policy update: Ambulance Transportation – Professional

Reimbursement PoliciesCommercialMarch 1, 2024

Reimbursement policy update: Laboratory and Venipuncture Services – Professional and Facility

Products & Programs

PharmacyMedicare AdvantageMarch 1, 2024

Overview of Medicare risk adjustment in-office prospective programs

PharmacyCommercialFebruary 22, 2024

Specialty pharmacy updates — March 2024

PharmacyBadgerCare Plus and Medicaid SSI ProgramsFebruary 21, 2024

Prior authorization updates for medications billed under the medical benefit

PharmacyCommercialMarch 1, 2024

Important information about your Anthem patients’ Botox prescriptions

PharmacyCommercialMarch 1, 2024

Designated specialty pharmacy network updates

PharmacyCommercialMarch 1, 2024

Pharmacy information available on our provider website

PharmacyCommercialFebruary 20, 2024

Prior authorization updates for therapeutic duplication of specialty drugs

PharmacyMedicare AdvantageFebruary 16, 2024

Anthem expands specialty pharmacy precertification list

PharmacyMedicare AdvantageJanuary 31, 2024

Notification of specialty pharmacy medical step therapy updates

Quality Management

Quality ManagementCommercialBadgerCare Plus and Medicaid SSI ProgramsMarch 1, 2024

Encourage Cervical Cancer Screening (CCS)

Quality ManagementCommercialBadgerCare Plus and Medicaid SSI ProgramsMarch 1, 2024

Cervical Cancer Screening (CCS) and Prenatal and Postpartum Care (PPC) for HEDIS

Quality ManagementCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsJanuary 29, 2024

HEDIS Breast Cancer Screening (BCS) update

Quality ManagementCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsFebruary 6, 2024

HEDIS 2024 documentation for Controlling High Blood Pressure (CBP) and Statin Therapy for Patients with Cardiovascular Disease (SPC)

Quality ManagementMedicare AdvantageFebruary 7, 2024

HEDIS® 2024 documentation for Care of Older Adults (COA)

Quality ManagementCommercialMarch 1, 2024

Boost annual preventive care visits: Tips and resources: An ounce of prevention is worth a pound of cure

WIBCBS-CDCRCM-051149-24

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