CommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsNovember 1, 2024

November 2024 Provider Newsletter

Featured Articles

Quality ManagementCommercialMedicare AdvantageBadgerCare Plus and Medicaid SSI ProgramsOctober 25, 2024

Time to prepare for HEDIS medical record review

AdministrativeCommercialOctober 23, 2024

Do you offer telehealth services? Let us know!

Education & TrainingBadgerCare Plus and Medicaid SSI ProgramsOctober 23, 2024

Reminder: take action to protect infants from respiratory syncytial virus this season

Education & TrainingMedicare AdvantageOctober 15, 2024

Model of Care training reminder


Administrative

AdministrativeCommercialNovember 1, 2024

Access to quality care

AdministrativeCommercialNovember 1, 2024

Personalized Match update

Digital SolutionsBadgerCare Plus and Medicaid SSI ProgramsNovember 1, 2024

Enhanced personalized match: making the care provider search more informed and personalized

Digital SolutionsCommercialNovember 1, 2024

Adopting digital member ID cards

Policy Updates

Policy UpdatesBadgerCare Plus and Medicaid SSI ProgramsOctober 2, 2024

Clarification to Carelon Medical Benefits Management, Inc. updates effective September 1, 2024

Policy UpdatesMedicare AdvantageSeptember 25, 2024

Carelon Medical Benefits Management, Inc. updates

Effective October 26, 2024

Policy UpdatesBadgerCare Plus and Medicaid SSI ProgramsSeptember 30, 2024

Carelon Medical Benefits Management, Inc. updates

Effective November 30, 2024

Medical Policy & Clinical GuidelinesBadgerCare Plus and Medicaid SSI ProgramsSeptember 24, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Effective October 26, 2024

Prior AuthorizationBadgerCare Plus and Medicaid SSI ProgramsOctober 10, 2024

Prior authorization requirement changes

Effective December 1, 2024

Prior AuthorizationMedicare AdvantageSeptember 24, 2024

Prior authorization requirement changes

Effective February 1, 2025

Reimbursement PoliciesCommercialNovember 1, 2024

Material adverse change

Reimbursement policy update: Nurse Practitioner and Physician Assistant Services

Products & Programs

Federal Employee Program (FEP)CommercialNovember 1, 2024

Submit corrected claims electronically for the Federal Employee Program®

PharmacyCommercialJuly 1, 2024

Material adverse change

Correction: Specialty pharmacy updates — July 2024

PharmacyCommercialOctober 24, 2024

Material adverse change

Specialty pharmacy updates — November 2024

PharmacyMedicare AdvantageNovember 1, 2024

Improving patient outcomes: back to the basics

Quality Management

Quality ManagementBadgerCare Plus and Medicaid SSI ProgramsOctober 24, 2024

Provider: CAHPS awareness

WIBCBS-CDCRCM-070470-24

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