News and updates

Learn the latest and greatest, starting October 8Our yearly Provider Workshops are an important event for healthcare professionals and service providers. You'll get all the updates on our plans and...

Updates on Existing CriteriaNovember 2024. The following changes to criteria are effective November 22, 2024:Prior Authorization Criteria –...

As part of our continued efforts to reinforce accurate coding practices, we are revising the current Emergency Department (ED) outpatient facility Evaluation and Management (E/M) coding reimbursement...

Updates on Existing CriteriaThe following changes to criteria are effective October 22, 2024:Prior Authorization Criteria – Clinical UpdatesArikayce...

We have recently updated our prior authorization list and coverage policies. These changes are effective for dates of service on or after September 15, 2024.Summary of changes...

IRS Notice 2014-55 (PDF) expands the situations in which individuals may change their health coverage elections under a Section 125 (cafeteria) plan.Please note that plans are not required...

Updates on Existing CriteriaAugust 2024. The following changes to criteria are effective August 22, 2024:Prior Authorization Criteria –...