Reminders and Updates

Additional drugs will require prior authorization under the drug site-of-service medical policy.

Request a conversation using the phone number in the denial notification letter.

New April 2025 codes covered for ambulatory surgery centers.

We’re implementing updates to certain codes to establish fixed pricing methodologies.

Follow these steps to avoid processing delays.

Prior authorizations submitted for 8 specific procedures in ambulatory surgery centers will be automatically approved.

New ambulatory surgery center codes for 2025.

Check before you test to make sure vitamin D screenings are medically necessary.

Here’s when you can expect them for 2025.

Sending one appeal per patient will help us process your appeals more quickly.

Learn about new Washington state requirements for cost-sharing, prior authorization, and reimbursement for HIV post-exposure prophylaxis drugs.

Additional information regarding new drug and biologic edits.

Drug waste will be reimbursed when billed with correct modifiers.

Include a description of the service rendered when billing an unlisted procedure code.

When is it appropriate for your patient?

Help reduce your patients’ out-of-pocket costs.

Mark your calendar for benefit changes effective July 1.

Make sure to append the correct modifier and number of units.

Comply with No Surprises Act requirements and verify your information with BetterDoctor.

Find the articles you need easier than ever.

Maximum daily units in claims editor explained.

LifeWise is expanding its formulary to include generic Fluticasone HFA.

Follow these simple steps to ensure you receive InstaMed autopayments in 2024.

New drug and biologic edits will be implemented to support medical and pharmacy policies.

90-day notice of changes for claims including an RA modifier.

Learn about the Cascade Select plans coming to Yakima County.

Recent sensor failures are not detecting correct blood sugar levels.

Changes are in store for preventive benefits in 2024.

Prior authorization requests must be re-submitted if attachments for more than one member are included.

Upcoming 2024 claims editing projects.