Updates & Announcements

We strive to make partnering with us simple. We’re aware things may change in the way we do business with you and want to communicate these changes to you in an efficient manner.

Quick References

Please note: The links below are in PDF format. If you do not have Adobe Acrobat Reader, you may download it here.

General Updates

2025Date
Navigate Align Provider Network Pharmacy Termination Disclosure12/02/2025
Navigate Policy Updates December 202512/01/2025
Navigate SKYGEN Policies12/01/2025
Navigate Prior Authorization Requirement Update12/01/2025
Navigate Telehealth and Remote Patient Monitoring 12/01/2025
Navigate Lymphedema Compression Treatment Items Claims Editing Enhancements11/24/2025
Navigate Policy Updates November 202511/01/2025
Navigate Launch of HealthPlanResources.com10/22/2025
Navigate Claims Editing - Add-On Codes, E/M and Special Services10/20/2025
Navigate Claim Edits for Durable Medical Equipment10/17/2025
Navigate New Claim Condition Code Requirements10/15/2025
Navigate Policy Updates October 202510/01/2025
Navigate DentaQuest Policy Updates September 202509/01/2025
Navigate September 2025 Policy Updates09/01/2025
Navigate Policy Updates August 202508/01/2025
Navigate Avalon Policy Updates - Q2 202507/01/2025
Navigate Coding Documentation Guides Available06/26/2025
Navigate ASH Acupuncture Policy Update - June 202506/01/2025
Navigate Provider Focus Group Invite05/19/2025
Navigate Policy Updates May 202505/01/2025
Navigate Prothesis and Orthosis Claims Editing Logic04/10/2025
Navigate Policy Updates April 202504/01/2025
Navigate Avalon Policy Update - April 202504/01/2025
Navigate Policy Updates March 202503/01/2025
Navigate Avalon Policy Updates - Q4 202403/01/2025
Navigate Policy Updates February 202502/01/2025
Navigate Avalon Policy Update - February 202502/01/2025
Navigate Updating Demographics01/01/2025
Navigate CMS Notice of Medicare Non-Coverage (NOMNC) Model Document Updates for Medicare Advantage Enrollees01/01/2025
Navigate Prior Authorization Requirement Update01/01/2025
Navigate Reminder - Prior Authorization Request and Appeals Process for Part B (Medical Drugs)01/01/2025
2024Date
Navigate Interactive Health Library12/06/2024
Navigate Policy Updates December 202412/01/2024
Navigate Avalon Policy Updates12/01/2024
Navigate 2025 Prior Authorization Update11/06/2024
Navigate Modifiers JZ and JW11/04/2024
Navigate November 2024 Policy Updates11/01/2024
Navigate QHP ESRD Notification – Notification is not applicable to D-SNP providers10/22/2024
Navigate QHP Hypoglossal/Allergen Modifiers Notification – Notification is not applicable to D-SNP providers.10/21/2024
Navigate October 2024 Policy Updates 10/01/2024
Navigate ICD-10-CM Excludes1 Note09/25/2024
Navigate Policy Updates September 202409/01/2024
Navigate ASH Acupuncture Policies08/01/2024
Navigate Policy Updates August 202408/01/2024
Navigate Change to Prior Authorization Request Process for Part B (Medical Drugs) – UPDATE07/01/2024
Navigate PharmScript Pharmacy Termination Disclosure07/01/2024
Navigate Prior Authorization Update06/04/2024
Navigate Q1 2024 Avalon Policy Updates06/01/2024
Navigate Policy Updates June 202406/01/2024
Navigate Change to Prior Authorization Request Process for Part B (Medical Drugs)05/31/2024
Navigate Visit the CareSource Health Equity Webpage for Resources and Trainings!05/20/2024
Navigate NIA/Evolent Policy Updates (Q2 2024) - May 202405/01/2024
Navigate DentaQuest Policy Updates (Q2 2024) - May 202405/01/2024
Navigate Policy Updates May 202405/01/2024
Navigate Provider Portal Claim Submission Tool Update04/11/2024
Navigate Policy Updates April 202404/01/2024
Navigate Availity Essentials Live Webinar Training03/06/2024
Navigate Change Healthcare Cybersecurity Incident03/04/2024
Navigate Policy Updates March 202403/01/2024
Navigate Q4 Avalon Policy Updates March 202403/01/2024
Navigate Member Balance Billing01/23/2024
Navigate Changes in D-SNP Pharmacy Coverage: Preferred Diabetic Part B Glucometers, Test Strips and Continuous Glucose Monitors (CGMs)01/03/2024
Navigate Avaolon Policy Updates - January 202401/01/2024
Navigate Policy Updates January 202401/01/2024
Navigate D-SNP Access to Care Updates01/01/2024
2023Date
Navigate Policy Updates December 202312/01/2023
Navigate Policy Updates November 202311/01/2023
Navigate 2024 Prior Authorization Requirement Updates10/19/2023
Navigate NIA Policy Updates October 202310/01/2023
Navigate Policy Updates October 202310/01/2023
Navigate Multi-Factor Authentication Implementation – UPDATE10/03/2023
Navigate Multi-Language Insert Requirement10/02/2023
Navigate Policy Updates September 202309/01/2023
Navigate Multi-Factor Authentication Implementation – UPDATE08/08/2023
Navigate Policy Updates August 202308/01/2023
Navigate August 2023 Avalon Policies08/01/2023
Navigate August 2023 DentaQuest Policies08/01/2023
Navigate August 2023 NIA Policies08/01/2023
Navigate Multi-Factor Authentication Implementation07/27/2023
Navigate Inflation Reduction Act Implementation Notice07/12/2023
Navigate Policy Updates June 202306/01/2023
Navigate Closing Diabetes Retinopathy Screening Care Gaps05/24/2023
Navigate Q3/Q4 Avalon Policies05/01/2023
Navigate Policy Updates May 202305/01/2023
Navigate Public Health Emergency Ending – Updates to Benefits and Rates04/10/2023
Navigate CAHPS Email Campaign and Quality Patient Experience Guide04/03/2023
Navigate Policy Updates April 202304/01/2023
Navigate White Bagging Prohibited: State-Issued Directive 03/22/2023
Navigate 2023 D-SNP and Ohio MyCare Model of Care Training Requirement03/14/2023
Navigate Member Balance Billing Update03/09/2023
Navigate Policy Updates March 202303/01/2023
Navigate 2023 Pharmacy Network Change02/23/2023