CommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsMay 1, 2024

May 2024 Provider Newsletter

Featured Articles

Digital SolutionsCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsMay 1, 2024

Digital Request for Additional Information is now available for all lines of business

Administrative

AdministrativeCommercialMedicare AdvantageMay 1, 2024

Carelon Post Acute Solutions, LLC will begin operating as Carelon Medical Benefits Management, Inc.

AdministrativeCommercialMay 1, 2024

CAA: Maintain your online provider directory information

AdministrativeBadgerCare Plus and Medicaid SSI ProgramsSeptember 1, 2023

After-hours messaging reminder

AdministrativeCommercialMay 1, 2024

Inaccurate laterality and diagnosis combination

AdministrativeMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsMay 1, 2024

Inaccurate laterality and diagnosis combination

Digital SolutionsMedicare AdvantageMay 1, 2024

Roster automation update

Digital SolutionsCommercialApril 23, 2024

Overview of the Preference Center on Availity Essentials

Digital SolutionsMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsApril 26, 2024

Introducing new functionality for non-medical providers

Digital SolutionsCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsApril 15, 2024

Coming soon — Submit behavioral health authorizations through the Authorization application on Availity

Digital SolutionsMedicare AdvantageMay 1, 2024

Personalized Match update

Education & Training

Education & TrainingCommercialApril 25, 2024

Instructions for donor claim billing

Education & TrainingCommercialMedicare AdvantageMay 1, 2024

Rotary to ground educational message

Education & TrainingBadgerCare Plus and Medicaid SSI ProgramsMarch 31, 2023

Ready, set, renew!

Policy Updates

Policy UpdatesBadgerCare Plus and Medicaid SSI ProgramsApril 24, 2024

Clinical Criteria updates — November 2023

Policy UpdatesBadgerCare Plus and Medicaid SSI ProgramsApril 19, 2024

Carelon Medical Benefits Management, Inc. updates

Policy UpdatesBadgerCare Plus and Medicaid SSI ProgramsApril 11, 2024

MCG Care Guidelines 27th edition update

Reimbursement PoliciesCommercialApril 3, 2024

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

Products & Programs

Federal Employee Program (FEP)CommercialMay 1, 2024

HEDIS tips: Adult Immunization Status (AIS-E)

PharmacyCommercialMay 1, 2024

Designated specialty pharmacy network updates

PharmacyCommercialApril 24, 2024

Specialty pharmacy updates — May 2024

PharmacyBadgerCare Plus and Medicaid SSI ProgramsApril 16, 2024

Prior authorization updates for medications billed under the medical benefit

Columvi, Izervay, Rystiggo, Vyvgart Hytrulo, and Eylea HD

PharmacyMedicare AdvantageApril 8, 2024

Anthem expands specialty pharmacy precertification list

PharmacyCommercialApril 9, 2024

Acquisition of Paragon Healthcare

PharmacyCommercialMarch 1, 2024

Pharmacy information available on our provider website

Quality Management

Quality ManagementCommercialBadgerCare Plus and Medicaid SSI ProgramsMay 1, 2024

Take action to improve adolescent immunizations rates

WIBCBS-CDCRCM-056148-24

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