Provider Alerts

As a provider, you are accountable for the information in this alert and when applicable, it will be incorporated into the Carelon Health of Pennsylvania Provider Manual.

2025 Provider Alerts

• PA 21.25.10 Reminder: Compliance with Pennsylvania Regulations
• PA 20.25.09 Timely Filing Notice for Providers Contracted with Beaver County
• PA 19.25.09 Introduction to Medetomidine
• PA 18.25.08 Changes to Expedited Fair Hearing Requests
• PA 17.25.07 Reminder Retro-Authorization Process
• PA 16.25.07 Update to Provider Manual on Mental Health Advanced Directives
• PA 15.25.06 Attention Carelon Health of Pennsylvania In-Network Methadone Providers
• PA 14.25.05 Prohibition of AI Meeting Assistants in Carelon Health of Pennsylvania Provider Trainings and Virtual Meetings
• PA 13.25.05 Statewide Intention and Commitment to Providers
• PA 12.25.05 New Treatment Opportunities for Providers
• PA 11.25.04 Carelon of Pennsylvania Quarterly Substance Use Disorder Provider Summits
• PA 10.25.04 Annual Training Reminder
• PA 09.25.03 DDAP Licensing Alert – 01-2025 Exceptions Related to 42 CFR Part 8
• PA 08.25.03 Update to Core Data Set Depression Screening Requirements
  • FAQ for Core Data Set Depression Screening
• PA 08.25.02 Update to Core Data Set Depression Screening Requirements
• PA 07.25.02 Availity Authorization and Claims Dashboard Down for Maintenance
• PA 06.25.02 Chapter 5240 Intensive Behavioral Health Services (IBHS) Regulatory Compliance Guide
• PA 05.25.01 Update to Limited English Proficiency Requirements
• PA 04.25.01 Core Data Set Depression Screening
• PA 03.25.01 OMHSAS-24-25 Peer Services Bulletin
• PA 02.25.01 Chapter 5210 Partial Hospitalization Regulatory Compliance Guide
• PA 01.25.01 Chapter 5200 Outpatient Psychiatric Clinic Regulatory Compliance Guide

2024 Provider Alerts

• PA 13.24.12 Reminder to Review Provider Summary Vouchers/Credits/Allocation of Claims
• PA 12.24.11 DDAP Licensing Alert – 07-2024 Exceptions Related to 42 CFR Part 8
• PA 11.24.11 Federal Final Rule Creates New Exception Options for “Four Walls” Rule
• PA 10.24.10 Annual Provider Education Webinars 2024
• PA 09.24.10 Reminder to Notify Carelon Health of Pennsylvania
• PA 08.24.08 OMHSAS Resource Guide for National Suicide Prevention Month
• PA 07.24.08 A Carelon of PA Message to Fiscal Officers About Member Eligibility
• PA 06.24.07 Carelon Health of Pennsylvania Update to Timely Filing Waiver Request Information
• PA 05.24.07 Carelon Health of PA Now Has a Separate Payer Space in the Availity Provider Portal
• PA 04.24.05 Carelon Health of PA’s Language Assistance Accommodation and Expectations
• PA 03.24.05 Carelon Reminder to Screen Employees
• PA 02.24.05 Memorial Day Check Run Schedule
• PA 01.24.01 Discontinuation of Performance Outcome Management System

2023 Provider Alerts

• PA 18.23.10 Continuing Use of American Society of Addiction Medicine Criteria, Third Edition
• PA 17.23.09 Reminder: Retro-Authorizations Process and Policy
• PA 16.23.07 ASAM Level of Care Assessments: Who is Qualified to Conduct a Level of Case Assessment
• PA 15.23.07 Is Your Information Accurate? Please Review Your Provider Portal for Our Members
• PA 14.23.06 Return to Authorization ASAM 3.7 3.5 and 3.1
• PA 13.23.05 OHMSAS Bulletin: Confidentiality of Records Changes and Aligning with HIPAA Act of 1996
• PA 12.23.05 Office of Mental health and Substance Abuse Services Announcement: Interim Telehealth Guidance
• PA 11.23.05 Department of Drug and Alcohol Programs Reminder: Regulatory Suspensions and End of the Public Health Emergency
• PA 10.23.05 Office of Mental Health and Substance Abuse Services Announcement: Notification of HIPAA Enforcement
• PA 9.23.05 Updated Timely Filing Waiver Request Process
• PA 8.23.04 Prohibition of Billing while Operating a Motor Vehicle
• PA 7.23.04 Return to Authorizations
• PA 6.23.03 Provider Billing Update
• PA 5.23.02 Beacon Health Options is becoming Carelon Behavioral Health
• PA 3.23.01 Office of Mental Health and Substance Abuse Services Announcement – Bulletin Suspension Information
• PA 2.23.01 COVID-19 Reporting Update
• PA 1.23.01 Invitation to Providers to Attend Webinar: Using Availity Essentials
• PA 4.23.02 Availity Essentials Resources

2022 Provider Alerts

• PA 9.22.12 Access, Availability and Health Equity Survey
• PA 8.22.12 Prior Authorization Requirements Update Effective September 1, 2022
• PA 7.22.11 Department of Drug and Alcohol Programs Confidentiality Guidance
• PA 6.22.11 Office of Mental Health and Substance Abuse Services Update
• PA 5.22.08 Monkeypox: Important Info for Providers
• PA 4.22.07 Authorization Parameters and KidNet for IBHS Providers
• PA 3.22.06 Language Assistance Program
• PA 2.22.03 Temporarily Waiving the Timely Filing Requirement
• PA 1.22.02 Prior Authorization Suspension Ending March 31, 2022

2021 Provider Alerts

• PA 11.21.11 Carelon COVID-19 Guidelines Update for November 2021
• PA 10.21.11 Medical Evaluation of Psychiatric and Substance Use Disorder Patients
• PA 9.21.11 Carelon Updated Fax Process
• PA 8.21.9 Use of Valproic Acid in Women and Girls of Childbearing Potential
• PA 7.21.9 Carelon Updated Timely Filing Waiver Request Process
• PA 6.21.9 Carelon COVID-19 Guidelines: Update at 18 Months
• PA 5.21.7 Carelon Expectations for Safe Discharge from Residential Care Settings
• PA 4.21.2 Carelon Expectations for ASAM Service Alignment
• PA 3.20.8 COVID-19 Guidelines in Ambulatory and Community-Based Care Settings
• PA 1.20.7 COVID-19 Guidelines in Congregate Care Settings
• PA 1.21.1 CPT Coding Change for Evaluation and Management

2020 Provider Alerts

• PA 6.20.12 Reimbursement for Licensed Practitioners
  • Reimbursement FAQs
• PA 5.20.11 Opioid Treatment Programs and Dual Eligible Members
• PA 4.20.9 COVID-19 Reporting Tool for All Carelon In-Network Providers
• PA 2.20.8 15-Minute Codes Added for Mental Health Partial Hospitalization

2019 Provider Alerts

• PA 9.19.12 Interpreter Services
• PA 8.19.10 Methadone Guest Dosing
• PA 7.19.10 Updated Outpatient Authorization Requirements
• PA 5.19.6 ACT 62 Process Change
• PA 4.19.6 Attending Taxonomy Code Revised
• PA 3.19.5 Guidelines for the Treatment of Opioid Use Disorders
• PA 2.19.6 Role of the Medical Director at Residential Treatment Facilities

2018 Provider Alerts

• PA 3.18.9 ORP Updated Billing Instructions
• PA 2.18.8 Ordering, Referring and Prescribing
• PA 1.18.6 Retro-Authorization Policy Reinforced

2017 Provider Alerts

• PA 4.17.8 TSS Prescription Schedule Initiative Modification
• PA 3.17.3 Place of Service Codes Are Being Updated
• PA 2.17.2 Paper Claims Submission Standards
• PA 1.17.2 Guidelines for the Approval of Telepsych Services in HealthChoices

2016 Provider Alerts

• PA 4.16.11 ICD-10 Coding Reminder
• PA 3.16.10 ICD-10 Updates
• PA 2.16.9 PROMISe Re-Enrollment/Revalidation
• PA 1.16.3 Provider Payment Suspensions Based on Credible Allegations of Fraud

2015 Provider Alerts

• PA 6.15.12 ICD-10 and Authorizations
• PA 5.15.12 Re-Enroll/Revalidate All Medical Assistance Programs Before the End of 2015
• PA 4.15.9 Authorizations and ICD-10 Coding Reminder
• PA 3.15.6 Place of Service Codes Reminder
• PA 1.15.4 Requesting Retro Authorizations for Members Moving from Private Care Option to HealthChoices

2014 Provider Alerts

• PA 10.14.12 Submitting Authorizations Electronically
• PA 9.14.10 Credentialing and Recredentialing – CAQH
• PA 8.14.8 E-Commerce Requirements.
• PA 7.14.7 DSM-5 Screens in ProviderConnect
• PA 6.14.4 Requests for Authorizations and Retro-Authorizations
• PA 5.14.2 ICD-10 Claims Process Rules
• PA 4.14.2 Payment for Diagnostic Laboratory Services in Outpatient Drug & Alcohol Clinics
• PA 3.14.2 Service Authorization Requirements
• PA 2.14.1 Family Based Providers – Units for Travel
• PA 1.14.1 Updated CMS-1500 Form

2013 Provider Alerts

• PA 1.13.5 Notification of Address Changes