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.

  • Pharmacy information, including our Preferred Drug Lists (PDLs)
  • Medical, pharmacy, reimbursement and administrative policies
  • Authorization requirements as communicated through network notifications below 

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

2019Date
NavigateDelay in Claim Payments11/13/2019
NavigatePolicy Updates November 201911/01/2019
NavigateDual-Eligibility Billing Reminder10/31/2019
NavigatePolicy Updates October 201910/01/2019
NavigateRegister with New Payment Partner ECHO Health by December 1 – UPDATE09/25/2019
NavigateRecent Provider Portal Updates – UPDATED 10/309/23/2019
NavigateConsent Form Upload Enhancement to the Provider Portal – UPDATE09/05/2019
NavigateEnhancements to Prior Authorization on Provider Portal09/05/2019
NavigateSeptember 2019 Policy Updates09/01/2019
NavigateIssue with Denials for Physical Therapy (PT) Units08/23/2019
NavigateIssues with Outpatient Claim Denials Due to Authorizations Expiring08/23/2019
Navigate2019-2020 Ohio Provider Manual Now Available08/06/2019
NavigateFacility Claim Cost Share08/01/2019
NavigatePolicy Updates August 201908/01/2019
NavigateRegister with New Payment Partner ECHO Health by October 25 – This notification has been revised. See notification dated 09/25/201907/26/2019
NavigateCoordination of Benefits (COB) Reminder07/22/2019
NavigateDuplicate Modifier on the Claim Service Line07/17/2019
NavigatePost-Payment Audit Update07/12/2019
NavigateProvider Dispute Process07/05/2019
NavigatePolicy Updates July 201907/01/2019
NavigateMulti-Factor Authentication Scheduled for SKYGEN CWP06/21/2019
NavigatePrior Authorization Enhancements for Observation Stays06/13/2019
NavigateInpatient Hospital Pre-payment Claims Reviews - Revised 6/6/201906/03/2019
NavigateUpdates to Marketplace Prior Authorization List05/31/2019
NavigatePolicy Updates June 201905/31/2019
NavigateTips to Improve Pediatric CAHPS Ratings05/29/2019
NavigateEnd-Stage Renal Disease (ESRD) Claims and Value Code D505/29/2019
NavigateDesignating a Supervising Provider Using Paper Claims05/17/2019
NavigateUpgrades to AHS Consent Form on the Provider Portal05/13/2019
NavigateAccess Standards Update05/06/2019
NavigatePolicy Updates May 201905/01/2019
NavigateApplied Behavior Analysis Rates and Pricing04/04/2019
NavigateUpdate to Emergency Room Cost Share Application04/01/2019
NavigatePolicy Updates April 201904/01/2019
NavigateEnhancements to Delivery and Newborn Notifications – UPDATE03/28/2019
NavigateApplied Behavioral Analysis (ABA) Billing and Coding03/27/2019
NavigateInterventions to Prevent Perinatal Depression03/13/2019
NavigateProvider Portal Survey03/07/2019
NavigatePolicy Updates May 201903/01/2019
NavigateHigh Dollar Claims02/19/2019
NavigateBehavioral Health Claim Issue Identified - UPDATE02/19/2019
NavigatePlace of Service Code for Claim Submissions02/14/2019
NavigateRevenue Code 0636 Denials Update02/13/2019
NavigateNational Drug Code (NDC) with J1050 Denials Update02/08/2019
NavigateEnhancements to Delivery and Newborn Notifications02/01/2019
NavigateHepatitis A Prevention Network Notification 01/29/2019
NavigateDiagnosis Related Group (DRG) Validation Audits01/21/2019
NavigateDental Eligibility Update01/11/2019
2018Date
NavigatePolicy Update March 201912/31/2018
NavigateClaim Denial Issue - Error Code X9412/27/2018
NavigateNotice of Changes to Retro Prior Authorization Timeframe Requirements12/26/2018
NavigateBehavioral Health Claim Issue Identified12/19/2018
NavigateIssues with Claim Denying for National Drug Code (NDC)12/14/2018
NavigateRemittance Delay for Wednesday, December 5, 2018 Payment Cycle12/07/2018
NavigatePolicy Updates January 2019 11/30/2018
NavigatePolicy Updates January 201911/01/2018
NavigateCode Advisor Network Notification10/23/2018
NavigateDuplicate Claim Processing Update09/01/2018
NavigatePolicy Updates November 201808/28/2018
NavigateWell-Child Care08/27/2018
NavigateConsent to Share Sensitive Health Information08/08/2018
NavigateClarification of Indiana Network Closure Communication07/30/2018
NavigateIncreasing Claim Payment Processing Frequency – UPDATE07/27/2018
NavigatePolicy Updates October 201807/27/2018
NavigateIncreasing Claim Payment Processing Frequency07/03/2018
NavigateNew Address for Refund Checks07/03/2018
NavigatePolicy Updates September 201806/29/2018
NavigateNotification of Claim Adjustments for Certain Edit Codes06/13/2018
NavigatePolicy Updates August 201806/12/2018
NavigateBreast Imaging Reimbursement Policy06/05/2018
NavigateCareSource Secure Email Portal Security Enhancements05/17/2018
NavigateUpdate to Provider Billing Address Requirements on Claims04/03/2018
NavigatePolicy Updates June 201803/30/2018
NavigateUpdate to Drug Testing Policy – UPDATE03/12/2018
NavigatePolicy Updates May 201802/28/2018
NavigateDiabetes Retinal Eye Exam01/25/2018
NavigateNew Approach to Educate and Reduce Evaluation and Management Billing Errors01/08/2018