View Reminders and Quick Tips for Medicaid Authorizations

In April 2026, we launched Medicaid Authorizations, an application you can access in Availity^® Essentials to help streamline requests for Illinois Medicaid members. Based on user feedback, we’ve compiled tips to help you navigate.

See Claims Reminders for Behavioral Health Services

Review guidance on submitting claims for services provided by trainees under supervision and out‑of‑network providers.

Watch for Digital Access to Prior Authorization Decision Letters via Availity Essentials

Beginning July 18, 2026, you’ll be able to view and securely download prior authorization decision letters through the Provider Correspondence Viewer within Payer Spaces.

We’re Updating Our Payment Systems To Help Improve Efficiencies

In July 2026, we’ll upgrade financial systems to modernize our payment processing technology. Learn what’s changing.

Learn More About Alacura for Medical Transportation Management

See frequently asked questions about medical necessity reviews of air and ground medical transportation services for some commercial members.

Submit Documentation to Blue Distinction^® Centers for Transplants by Email or Fax

We’ve retired the mailing address for Blue Distinction Centers for Transplants. Learn how to submit documentation by email or fax, effective immediately.

See Prior Authorization Changes for Some Government Program Members

We’ve updated prior authorization requirements for certain government plans to reflect new, replaced or removed codes.

Ask Members To Complete a Depression Screening

Primary care providers can help our members by asking them to complete a screening and encouraging follow‑up care with behavioral health care providers when appropriate.

Avoid Imaging for Low Back Pain When Not Indicated

To support appropriate care for our members, we track the quality measure Use of Imaging Studies for Low Back Pain. Review tips and appropriateness criteria.

Earn Continuing Education Credit Through Maternal Health Webinars

The Morehouse School of Medicine Center for Maternal Health Equity is offering two courses that provide a continuing education unit at no cost to you. Learn how to register.

Explore Learning Opportunities

We offer free webinars and workshops for providers who participate in our networks. View the schedule and sign up for training sessions, including a webinar on men’s mental health that offers continuing education credit.

MTM Health To Provide Medical Transportation for Medicaid Members

We’ll transition from Modivcare to MTM Health as the sole provider of nonemergency medical transportation for our members with Medicaid coverage, effective Oct. 1, 2026.

Encourage Medicare Members To Respond to Health Outcomes Survey

The Centers for Medicare & Medicaid Services surveys a sample of our members to rate their care. Learn about survey topics our members may discuss with you.

Watch for Our Provider Availability and Access Survey

Your response helps ensure compliance with wait time standards for primary care, specialty and behavioral health services.

Review Rights and Responsibilities

As a participating provider, you have certain rights and responsibilities that may affect your practice. Learn about your rights and responsibilities and those of our members.

See the Latest Pharmacy Prior Authorization Changes

We’re updating our standard pharmacy prior authorization programs. Changes affect members with prescription drug benefits administered by Prime Therapeutics^®. Review what’s changing as of June 1, 2026.

Learn About Updates to Reimbursement Policies

We regularly add and modify reimbursement policies, formerly known as clinical payment and coding policies, as part of our ongoing policy review. See which policies were updated.

Review Active and Pending Medical Policies

Approved new or revised medical policies and their effective dates are usually posted on our website the first and 15th of each month. You can view all active and pending policies, as well as draft medical policies, and provide comments on draft policies. These policies may impact your reimbursement and your patients’ benefits.