News and Updates

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Provider alerts

October 23, 2025AmeriHealth Caritas NEXT Delaware At a Glance (PDF)
October 22, 2025HEDIS Measures for Patients with Diabetes (PDF)
October 21, 2025HEDIS Screening Measures: Breast Cancer, Colorectal Cancer, and Cervical Cancer Screenings (PDF)
October 16, 2025Beware of phishing scams — don’t take the bait! (PDF)
October 15, 2025Exchange risk adjustment overview and documentation guidance (PDF)
October 14, 2025Provider Self-Service through NaviNet (October Update) (PDF)
October 13, 2025Concomitant Use of CGRP Antagonists (PDF)
October 8, 2025Help Us Improve Member and Provider Relationships by Sharing Your Demographic and Language Data (PDF)
October 7, 2025Provider Data Information Form (PDF)
October 6, 2025Important billing reminder (PDF)
October 2, 2025Additional Provider Incentive Program (PDF)
October 1, 2025Organ transplant initial evaluation notification (PDF)
October 1, 2025Prior authorization changes for select CPT/HCPCS codes (PDF)
September 29, 2025Care Optimization program — Introducing Edifecs' Clinical Insights (CI) (PDF)
September 24, 2025Provider Manual Revisions (January 2026) (PDF)
September 24, 2025Claims and Billing Manual revisions (October 2025) (PDF)
September 12, 2025Post Appointment Survey Provider Scorecard in NaviNet (PDF)
September 9, 2025Formulary update (October 15, 2025) (PDF)
September 2, 2025Guidance to use the correct payer ID (PDF)
August 27, 2025Prior authorization requests (PDF)
August 19, 2025Exchange risk adjustment overview and documentation guidance (PDF)
August 18, 2025Balance or surprise billing reminders (PDF)
August 14, 2025Can you spot the phish? (PDF)
August 8, 2025Change Healthcare ConnectCenter™ Update (PDF)
August 6, 2025Tips to avoid timely filing and other common claim denials (August 6 Update) (PDF)
August 5, 2025Access and availability provider alert (PDF)
August 4, 2025NaviNet Claims Investigation Attachments (PDF)
August 1, 2025

NaviNet claims overpayment recovery response process (PDF)

July 31, 2025Anesthesia Reimbursement Policy reminder (PDF)
July 30, 2025

Member Reward Card (PDF)

July 29, 2025Formulary update (September 1, 2025) (PDF)
July 25, 2025Humira Biosimilars Updates (July 2025) (PDF)
Nostrum Laboratories, Inc. Issues Voluntary Nationwide Recall of Sucralfate Tablets USP 1 Gram Within Expiry (PDF)
July 24, 2025Provider Manual revisions (July 2025) (PDF)
July 23, 2025

Claims and Billing Manual revisions (July 2025) (PDF)

July 21, 2025HEDIS IET Provider Education Tip Sheet (PDF)
July 14, 2025

Provider self-service through NaviNet (PDF)

July 8, 2025Provider Data Information Form (PDIF)
July 3, 2025Important billing reminder (PDF)
June 30, 2025Risk Adjustment Program — new vendor, UST HealthProof (PDF)
June 27, 2025Supporting documentation for prior authorization requests (PDF)
June 20, 2025New vendor to provide in-home health evaluations (IHE) (PDF)
May 29, 2025Practitioner credentialing rights (PDF)
May 28, 2025Formulary update (July 15, 2025) (PDF)
May 20, 2025Save the date — claims overpayment response process (PDF)
May 14, 2025Participating provider office standards for access and availability (PDF)
May 5, 2025Tips to avoid timely filing and other common claim denials (PDF)
May 1, 2025Stelara biosimilar medications (PDF)
April 29, 2025Blood Pressure Communication Program (PDF)
April 16, 2025GLP-1 medications (PDF)
April 14, 2025Provider self-service through NaviNet (April update) (PDF)
April 7, 2025Provider data information form (PDIF) (PDF)
April 4, 2025Important billing reminder (PDF)
March 18, 2025Electronic pharmacy prior authorization (PDF)
March 11, 2025Formulary updates (April 15, 2025) (PDF)
March 4, 2025Guidance to use the correct payer ID (PDF)
February 18, 2025Exchange risk adjustment overview and documentation guidance (PDF)
February 17, 2025Balance or surprise billing reminders for Delaware Next members (PDF)
February 14, 2025Additional weekly payments added (PDF)
February 3, 2025Tips to avoid timely filing and other common claim denials (PDF)
January 31, 20252025 PerformPlus® Gaps in Care Closure Program (PDF)
January 22, 2025Ways to avoid common errors in electronic prior authorization submissions (PDF)
January 14, 2025HEDIS advance notice of Palm Quest and Reveleer (PDF)
January 13, 2025Provider self-service through NaviNet (PDF)
January 6, 2025Provider Data Information Form (PDIF) January 2025 update (PDF)
January 2, 2025Important billing reminder for providers (PDF)

Provider Alerts Archive