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Aug 11, 2023
Effective August 1, 2023, Carelon Medical Benefits Management, our medical benefits manager, began performing medical necessity reviews of procedures we previously conducted. This change applies to all fully insured, local ASO, and National groups with Wellbeing Solutions programs. It will improve the member and provider experiences by simplifying prior authorization processes. Additional codes may be added to the review process during this transition.
We’ve let our groups know about this transition, but the change is seamless to them and their employees. There’s no action you or your clients need to take, but we wanted you to be aware.
Small Businesses are the engine that drives communities across America. This month we honor and celebrate those businesses and commit to our continuing collaboration to build healthy communities where people and businesses thrive. We recently shared this small-business video with your client gro...
Ohio law requires insurers offering health care plans through a health insurance exchange to make the following information available to existing and potential members upon request: A list of the top 20% of services based on use An insured's expected contribution for each service The top 20...