2024 News and Updates

12/20/24 PEAQ^SM Program Adds New Specialties for Cost Efficiency Analysis
12/19/24 Records Needed to Support Quality Care for Medicare Advantage Members
12/19/24 Ensure Your Office Is Providing Your Most Current Information
12/18/24 Medical Records Collection for Federal Employee Program^® Begins in February
12/17/24 Prior Authorization Changes for Medicare Advantage and Healthy Montana Kids Effective April 1, 2025
12/17/24 Prior Authorization Codes Updated for Commercial Members Effective April 1, 2025
12/13/24 Remind Billing Agencies to Correctly Submit Claim Review Requests
12/12/24 Follow-Up Care Is Recommended for Children Prescribed ADHD Medication
12/10/24 ClaimsXten™ Quarterly Update Effective March 17, 2025 
12/09/24 Solutions and Results Monitoring for Gene Therapy Treatments to Launch in 2025
12/06/24 Medicare Providers May Treat Members of Blue Cross Group Medicare Advantage Open Access (PPO)^SM
12/05/24 Remind Our Members about Cervical and Breast Cancer Screenings
12/04/24 CMS Tracks High-Risk Medication Combinations with New Part D Quality Measures
12/03/24 Keep Your Contact Information Updated to Receive Recredentialing Reminders
11/26/24 Funds to Be Recouped on Some Medicare Advantage Hospital and Ancillary Claims
11/22/24 Preferred Drugs to be Recommended Through Enhanced Prior Authorization
11/19/24 Learn About Our 2025 National Drug Code Fee Schedule Impact and Timeline
11/18/24 Coding Reference for Quality Measures Is Available to Help Identify Gaps in Care
11/15/24 Order a Sufficient Supply of Bicillin^® L-A for Syphilis Treatment 
11/13/24 Cultural Awareness Webinars: No-Cost Continuing Education Credit
11/12/24 Follow Centers for Medicare & Medicaid Services Guidelines for Appointment Wait Time Standards
11/06/24 Pharmacy Program Quarterly Update Changes Effective Jan. 1, 2025 – Part 1
11/05/24 Update: Delay in posting latest National Drug Code fee schedules
11/01/24 Prior Authorization Changes for Medicare Advantage Members Effective Jan. 1, 2025
10/29/24 How to Submit Photos to Accompany Prior Authorization or Recommended Clinical Review
10/28/24 CDC Recommends Prescribing Doxy PEP to Prevent Sexually Transmitted Infections
10/24/24 Code Effectively to Earn Additional Incentive Payments
10/23/24 Talk to Our Members About the Flu Vaccine
10/17/24 Update: Select Self-Administered Drugs Moving to Pharmacy Benefit Effective Mar. 1, 2025
10/16/24 Encourage Annual Eye Exams for Our Members with Diabetes
10/16/24 Statin Therapy Is Recommended for Patients with Cardiovascular Disease and Diabetes
10/15/24 Medicare Prescription Payment Plan Launching Jan. 1, 2025
10/10/24 Care Coordination Can Help Our Members After Hospital Discharges
10/08/24 Risk Identification and Outreach Program Supports Member Safety
10/02/24 Acquisition of Cigna Healthcare Medicare Business in 2025
10/01/24 Check ID Cards for New Coupe Health Plan Members
10/01/24 Updates Coming to Behavioral Health Substance Abuse Criteria for Utilization Management
10/01/24 Out-of-State Care Beyond Contiguous Counties No Longer Covered Benefit for Individual and Family Market Members
09/30/24 Prior Authorization Codes Updated for Commercial Members Effective Jan. 1
09/27/24 Pharmacy Program Quarterly Update Changes Effective Oct. 1, 2024 – Part 1
09/26/24 Utilization Management Review Expanding for Advanced Imaging for Some Commercial Members Jan. 1, 2025
09/13/24 Register for a Coding Webinar on Coagulation Defects and Other Hematological Disorders
09/09/24 ClaimsXten™ Quarterly Update Effective Dec. 9, 2024
09/05/24 Closing Care Gaps in Child and Adolescent Weight Assessment and Nutrition Counseling
09/04/24 Reminder: Submit Claims and Inquiries to Correct PO Boxes to Avoid Delays
09/04/24 Use the Updated Claims Referral Form for American Indian/Alaska Native Limited Cost Share Plans
08/20/24 Free Webinar Focuses on Angioedema and Asthma
08/20/24 Watch for our Provider Availability and Access Survey
08/15/24 Physician Performance Insights Reports Are Now Available
08/15/24 Shared Decision-Making Aids Can Help Guide Care Choices
08/14/24 Register for Webinars on Coding for Stroke, Cancers and Heart Failure
08/13/24 Check Member ID Cards for New Coupe Health Plan Members
08/12/24 30-Day Supply Limit: Select Commercial Members Have New Pharmacy Benefit for GLP-1 and/or Anti-Obesity Drug Therapy
08/08/24 Encourage Medicare Members to Respond to Health Outcomes Survey
08/01/24 Pharmacy Program Quarterly Update Changes Effective Oct. 1, 2024 – Part 1
08/01/24 Prior Authorization Changes for Healthy Montana Kids Members, Effective Oct. 1, 2024
07/30/24 Abiraterone Drug Coverage Changes for Many Commercial Members Set for Oct. 1
07/25/24 New Blue Review publication, content deadline schedule begins in September
07/23/24 Provider Finder^® to Rank Providers to Help PPO Members Find Care
07/22/24 Medicare Providers May Treat Blue Cross Group Medicare Advantage Open Access (PPO)^SM Members
07/16/24 Has Your Information Changed? Update Us and the NPI Registry
07/10/24 Earn Continuing Education Credit: Webinar on Avoiding Inappropriate Antibiotic Use
07/10/24 Member Rights and Responsibilities
07/03/24 New menu option added to Interactive Phone System - Check Authorization by Procedure Code
07/02/24 Physician Performance Insights Reports Coming Soon from PEAQ
07/02/24 Provider Rights and Responsibilities
07/02/24 In-Home Test Kits for Colorectal Cancer Screening
06/27/24 Breast Cancer Screening for Members Ages 40 to 74
06/26/24 Pharmacy Program Quarterly Update Changes Effective July 1, 2024 - Part 2
06/25/24 Prior Authorization Changes for Medicare Advantage and Healthy Montana Kids Members
06/25/24 Prior Authorization Codes Updated for Commercial Members Effective Oct. 1
06/25/24 Proper Billing for Supplies for Transcutaneous Electrical Nerve Stimulation Units
06/24/24 Coming Soon – New Learning & Training Center in Availity^® Essentials
06/24/24 New Coupe Health Plan: Update Your Member Records
06/11/24 GLP-1 New to Therapy Optional Benefit Program Available for Select Commercial Members
06/07/24 Delay in Spinal Service Transition to Carelon
06/05/24 Encourage Routine Vaccines and Well-Care Visits for Children and Teens
05/30/24 Prior Authorization Requests May Be Needed Due to Pharmacy Claims Processing Error
05/24/24 Updated: See Our Revised Coding and Compensation Policy for Anesthesia Services
05/24/24 Updated PEAQ^SM Methodology Is Now Available
05/22/24 Earn Continuing Education Credit: Webinar on Trauma-Informed Care
05/20/24 Access MCG Care Guidelines Clinical Criteria via Availity®
05/09/24 Behavioral Health Consultations During Hospitalization Can Improve Outcomes
05/08/24 Helping Our Members Manage Diabetes
05/08/24 ClaimsXten™ Quarterly Update Effective Aug 19, 2024
05/07/24 Closing Gaps in Care for Group Medicare Advantage (PPO) Members
05/03/24 Reminder: Use New Mailing Address for Paper Commercial Claims to Avoid Mail Delays
05/02/24 Pharmacy Program Quarterly Update Changes Effective July 1, 2024 - Part 1
05/01/24 Electronic Claim Review and Ensuring the Correct Use of our Claim Review Form
05/01/24 Supporting Maternal Quality Care
04/30/24 Late and Added Charges Must Be Submitted as a Corrected Claim
04/30/24 Reminder to Update Profile for Accreditation
04/22/24 How to Reach Out with Questions about 1099 Forms
04/22/24 Important Updates to Manage My Organization in Availity Essentials
04/05/24 Clarification Regarding Provisional Credentialing for TriWest Network
04/04/24 Filing Claims for Behavioral Health Services – Use the Correct Place of Service Code
04/03/24 Coding Webinars: Arrhythmias and Rheumatoid Arthritis
04/01/24 2024 Fee Schedule and Compensation Policy Update
03/29/24 Pharmacy Program Quarterly Update Changes Effective April 1, 2024 - Part 2
03/28/24 Prior Authorization Codes Updated for Commercial Members
03/26/24 Prior Authorization Changes for Medicare Advantage and Healthy Montana Kids Members
03/12/24 Reminder: Make Sure your Rates are Up To Date
03/12/24 Closing Gaps in Colon Care
03/11/24 Earn Continuing Education Credit: Webinar on Substance Use Disorder
03/05/24 ClaimsXten™ Quarterly Update Effective June 17, 2024
03/05/24 Webinar on Coding for Medicare Advantage Annual Wellness Visits
03/04/24 Caring for Substance Use Disorders
03/04/24 Change Healthcare Cybersecurity Incident Impact and Options
02/26/24 Reminder: New Updates to Claim Editing Changes for Emergency Department Services
02/26/24 Revised Coding and Compensation Policy for Anesthesia Services
02/21/24 Musculoskeletal Spinal Surgery Prior Authorization Codes Updated for Commercial Members, Effective April 22, 2024
02/20/24 Earn Continuing Education Credit: Webinar on Social Determinants of Mental Health Care
02/16/24 30-Day Facility Readmission Reviews for Medicare Advantage Members
02/09/24 Avoiding the Inappropriate Use of Antipsychotic Medication in Anxiety Disorders
02/06/24 Pharmacy Program Quarterly Update Changes Effective April 1, 2024 - Part 1
02/06/24 Follow-up Care for Mental Health
02/01/24 Reminder: Update Your Records with New Mailing Addresses
01/30/24 Updated Provider Manuals Now Available
01/30/24 Changes to Claim Inquiry Resolution
01/25/24 Medicare Advantage HEDIS Records Collection through June 2024
01/22/24 Earn Continuing Education Credit at Webinar on Pediatric Behavioral Health
01/19/24 Changes Coming to Claim Inquiry Resolution
01/16/24 Coding Webinars: Major Depressive Disorder and Annual Wellness Visits
01/09/24 Pharmacy Program Updates: Quarterly Pharmacy Changes Effective January 1, 2024 - Part 2
01/08/24 ClaimsXten™ Quarterly Update Effective April 15, 2024
01/08/24 Supporting Healthy Hearts
01/08/24 Managing Antidepressant Medication
01/08/24 FEP^® HEDIS Records: Collecting February through April 2024
01/05/24 Monitoring Children Using ADHD Medication
01/05/24 Hospitals Must Provide Medicare Outpatient Observation Notice
01/05/24 Patients in the Qualified Medicare Beneficiary Program Should Not Be Billed
01/04/24 Prior Authorization Changes for Medicare Advantage Members
01/04/24 Prior Authorization Codes Updated for Commercial Members
01/04/24 Update Your Records: New Medicare Open Access PPO Members and ID Cards
01/04/24 Remind Our Members about Cervical and Breast Cancer Screenings
01/04/24 Reminder: Update Your Records with New Mailing Addresses