Authorization news for providers
- 05/14/2025: New DME auth requirement for Q0508
- 04/02/2025: Authorization appeal update effective June 2
- 04/02/2025: Reminder EviCore radiation oncology authorizations and resources
- 04/02/2025: 2025 InterQual transition coming June 2
- 03/19/2025: Authorization requests for 73700 and 73200 now auto approve
- 02/19/2025: New prior authorization requirement for cardiac procedures
- 02/05/2025: New authorization requirement for renal denervation
- 02/05/2025: Reminder callbacks not possible for inpatient P2P cases
- 01/22/2025: Updated TurningPoint provider training guide available
- 01/07/2025: New authorization requirement for non-urgent inpatient hospital transfers
- 12/13/2024: Reminder of varicose vein authorizations implementation
- 11/20/2024: Photos required with home health wound care auths after 90 days
- 11/20/2024: Peer-to-peer policy update cancelled
- 11/07/2024: TurningPoint portal scheduled downtime
- 10/30/2024: TurningPoint authorizations resources and information
- 10/17/2024: Delayed implementation of varicose vein authorizations
- 10/10/2024: CGM authorization timeframes by plan type
- 09/11/2024: Reminder - Radiation oncology auth program launches Sept 15
- 08/27/2024: Peer-to-peer policy update delayed
- 08/22/2024: Our authorization request form has a new look
- 08/22/2024: TurningPoint launches for cardiac and MSK authorizations
- 08/08/2024: Procedure codes impacted by new auth programs
- 08/07/2024: Resources and trainings for TurningPoint authorizations
- 07/31/2024: Finalizing 2024 InterQual criteria transition
- 07/29/2024: EviCore radiation oncology provider trainings
- 07/15/2024: Portion of 2024 InterQual criteria delayed
- 07/10/2024: Provider trainings for TurningPoint authorizations programs
- 07/10/2024: Outpatient peer-to-peer reviews to follow new policy
- 06/04/2024: Inpatient peer-to-peer policy update goes into effect September 4
- 06/04/2024: New radiation oncology authorizations program to launch this fall
- 05 30 2024 provider news New MSK prior auth program starts Sept 1
- 05/22/2024: Ensure proper clinical documentation for authorizations
- 05/17/2024: Standard vs expedited authorization requests
- 04/07/2024: InterQual updating to 2024 criteria on July 15
- 03/21/2024: New cardiology authorizations program to launch this summer
- 02/07/2024: Acute inpatient authorization denial calls stop April 8
- 01/11/2024: PSODs are required for services not covered by Medicare
- InterQual is operational again
- 06/08/2023: InterQual outage impacts prior authorizations nationwide
- 05/11/2023: We're transitioning to 2023 InterQual on July 17
- 05/09/2023: Two Midnight Rule: Our UM practices remain unchanged
- 05/02/2023: CPT code 99222 no longer used for authorizations
- 04/21/2023: Simplifying home health authorizations
- 04/17/2023: New pop-ups in GuidingCare
- 03/31/2023: Clinical documentation required for outpatient authorizations on June 1
- 03/28/2023: Making health care easier and more transparent with Public Act 60
- 10/27/2022: Prior authorization no longer required for two CPT codes
- 08/30/2022: New prior authorization requirements for bariatric surgery
- 08/23/2022: Prior authorization is now required for IMRT services
- 8/22/2022: GuidingCare upgrade and new authorization guides are live
- 08/11/2022: GuidingCare will be down the weekend of August 19
- 07/27/2022: GuidingCare tips: InterQual Smartsheets and messages
- 06/30/2022: Ensuring accurate Elective Inpatient Admission authorization reviews
- 06/21/2022: GuidingCare upgrade, 2022 InterQual criteria update coming this August
- 02/04/2022: Provider news tips to successfully complete InterQual review
- 01/07/2022: Notice of admission isn't required for our Medicare members
- 12/30/2021: Our 2022 prior authorization updates are live
- 11/15/2021: New functioning coming to GuidingCare
- 11/10/2021: Starting Nov. 15, pediatric tonsillectomies no longer require authorization
- 11/01/2021: Important 2022 prior authorization updates
- 10/25/2021: SCOE retiring Jan. 1, 2022
- 10/15/2021: We're upgrading to InterQual 2021
- 10/07/2021: Oct. 15 specific services transition to 2021 InterQual
- 09/28/2021: Assist members transferred from THC with updating their medications
- 08/18/2021: 2021 CMS Inpatient Only list is delayed
- 08/12/2021: GuidingCare down the weekend of Aug. 20
- 08/12/2021: 2021 InterQual criteria is delayed
- 08/11/2021: Enhancements to GuidingCare coming Aug. 23
- 07/28/2021: GuidingCare transitioning to 2021 CMS Inpatient Only list
- 07/02/2021: Musculoskeletal authorization updates
- 06/21/2021: 2021 InterQual
- 04/05/2021: ADT enhancement
- 03/19/2021: MSK moving to GuidingCare
- 03/02/2021: 2021 MSK change in April
- 02/11/2021: Update to eviCore retrospective authorizations
- 01/29/2021: eviCore retro genetic labs