TurningPoint annual provider survey
TurningPoint, which manages cardiac and MSK authorizations on our members’ behalf, is inviting our providers to participate in the Annual TurningPoint Provider Survey.
11/10/25: P2P update for Medicare inpatient acute authorizations
Effective Jan. 1, 2026, we’ll offer peer-to-peer reviews (P2Ps) for Medicare inpatient acute authorizations before issuing a denial, rather than after.
10/15/25: Varicose vein authorizations updates
We’re sharing two updates regarding varicose vein procedure authorizations.
09/25/2025: Home health care authorizations update
Many home health care services no longer require prior authorization for our in-network providers, effective Sept. 1, 2025.
09/17/2025: Reminder: Medicaid members now receive inpatient denial letters
To comply with a recent decision by the Centers of Medicare and Medicaid Services (CMS), Medicaid members whose authorization requests for inpatient services were denied now receive denial letters in the mail.
09/10/2025: Withdrawing pending authorizations through GuidingCare is temporarily unavailable
Effective Sept. 10, 2025, providers are temporarily unable to withdraw pending authorizations from GuidingCare directly.
Wheelchair authorizations: request only the duration needed
When submitting wheelchair authorization requests for our members, our utilization management team asks that you now request only the duration you anticipate the member will need based on their condition.
TurningPoint post-claim appeal updates
We’re sharing a couple of updates on post-claim appeals for medical necessity for cases managed by TurningPoint.
Delayed implementation of varicose vein authorizations
Implementation of prior authorization requirements for certain varicose vein procedures is delayed.
CGM authorization timeframes by plan type
We’re sharing a quick reminder of our allowed continuous glucose monitor (CGM) authorization timeframes by plan type.
Reminder: Our radiation oncology authorization program with EviCore launches Sept 15
Our radiation oncology authorizations program with EviCore, first announced in June, will launch on September 15.
Peer-to-peer policy update delayed
Implementation of our recently-announced peer-to-peer policy for inpatient requests is delayed while we gather network feedback.