Updates & Announcements

We strive to make partnering with us simple. We’re aware things may change in the way we do business with you and want to communicate these changes to you in an efficient manner.

Quick References

Please Note: The links below are in PDF format. If you do not have Adobe Acrobat Reader, you may download it here.

Georgia Pathways

The Pathways to Coverage Program began on July 1, 2023. For more information about the program, please visit https://dch.georgia.gov/georgiapathways.

General Updates

2024Date
Navigate Policy Updates December 202412/01/2024
Navigate CareSource Dental Plan Update11/18/2024
Navigate 1309 Medically Necessary Contact Lenses Policy Notification11/01/2024
Navigate 1330 Specialty Spectacle Lense Policy Notification11/01/2024
Navigate Policy Update - PY-1543 - November 202411/01/2024
Navigate Policy Update - MM-0212 - November 202411/01/2024
Navigate Policy Updates November 202411/01/2024
Navigate Prior Authorization Requirement Update10/22/2024
Navigate Policy Updates October 202410/01/2024
Navigate Hospital Outpatient Lab Pricing Update – Second Revision09/26/2024
Navigate ICD-10-CM Excludes1 Note09/25/2024
Navigate Single Dose Vial-Claims Modifiers09/06/2024
Navigate Pharmacy Policy Updates September 202409/01/2024
Navigate Policy Updates September 202409/01/2024
Navigate Hospital Outpatient Lab Pricing Update Revision08/16/2024
Navigate PeachCare for Kids - Copay Reinstatement08/15/2024
Navigate Prior Authorization Requirement Update08/08/2024
Navigate Policy Updates August 202408/01/2024
Navigate Hospital Outpatient Lab Pricing Update07/10/2024
Navigate CareSource Partnering with LIBERTY Dental Plan – UPDATE07/02/2024
Navigate Avalon Q1 2024 Quarterly Laboratory Policy Updates07/01/2024
Navigate Policy Updates July 202407/01/2024
Navigate Prior Authorization Update06/14/2024
Navigate Provider Satisfaction Survey06/12/2024
Navigate Pharmacy Policy Updates June 202406/01/2024
Navigate Policy Updates June 202406/01/2024
Navigate Clinical Performance Improvement Plan for Postpartum Care and Hypertensive or Pre-Eclampsia Members05/22/2024
Navigate Visit the CareSource Health Equity Webpage for Resources and Trainings!05/16/2024
Navigate Non-Emergency Medical Transportation (NEMT)05/14/2024
Navigate 2024 Member Well-Child Visit and Vaccine Raffle05/10/2024
Navigate NIA/Evolent Policy Updates (Q2 - 2024) - May 202405/02/2024
Navigate CareSource Cardiac and Musculoskeletal Surgical Quality and Safety management Program in Partnership with TurningPoint – UPDATE05/02/2024
Navigate Policy Updates May 202405/01/2024
Navigate Avalon Policy Updates (Q4 - 2023) - May 202405/01/2024
Navigate Provider Portal Claim Submission Tool Update04/11/2024
Navigate Policy Updates April 202404/01/2024
Navigate CareSource Cardiac and Musculoskeletal Surgical Quality and Safety Management Program in Partnership with TurningPoint – This notification has been revised. Please see notification dated 5/2/2403/18/2024
Navigate It's Patient Experience Survey Season!03/12/2024
Navigate Change Healthcare Cybersecurity Incident03/11/2024
Navigate Q3 Avalon Policy Updates03/01/2024
Navigate Policy Updates March 202403/01/2024
Navigate Policy Updates March 202403/01/2024
Navigate Pharmacy Policy Updates March 202403/01/2024
Navigate Closing Diabetes Retinopathy Screening Care Gaps02/19/2024
Navigate Newly Covered Codes for Prior Authorization02/16/2024
Navigate Newborn and NICU Prior Authorization Requirement01/12/2024
Navigate Dental Authorization Request Process01/04/2024
Navigate TurningPoint Policy Updates January 202401/01/2024
2023Date
Navigate Behavioral Health PIP for Adolescent Depression Screening12/22/2023
Navigate Dental Claim Submission Update12/11/2023
Navigate Avalon Policy Updates December 202312/01/2023
Navigate CareSource Cardiac and Musculoskeletal Surgical Quality and Safety Management Program in Partnership with TurningPoint – This notification has been revised. Please see notification dated 03/18/202412/01/2023
Navigate Pharmacy Policy Updates December 202312/01/2023
Navigate Policy Updates December 202312/01/2023
Navigate Updated Dental Provider Resources11/22/2023
Navigate Dental: Post-Treatment (Retrospective Review) - Process Clarification11/21/2023
Navigate Public Health Emergency Ending – Update to Member Benefits11/13/2023
Navigate REVISED Provider Revalidation – Deadline EXTENDED11/08/2023
Navigate 2023 Quality Enhancer Program Termination11/07/2023
Navigate 2024 Obstetrics Quality Program11/07/2023
Navigate UPDATE: 2023 Quality Enhancer Program for Providers Not Enrolled in a VBR11/01/2023
Navigate NIA Policy Updates - November 202311/01/2023
Navigate Versant Policy Updates - November 202311/01/2023
Navigate Policy Updates November 202311/01/2023
Navigate REVISED Provider Revalidation - Deadline EXTENDED10/20/2023
Navigate Human Papillomavirus Vaccine Series10/12/2023
Navigate Oncology Drug Shortage Notification10/12/2023
Navigate Policy Updates October 202310/01/2023
Navigate Avalon Policy Updates - Q2 202310/01/2023
Navigate Avalon Policy Updates - Q1 202310/01/2023
Navigate Pharmacy Policy Updates November 202310/01/2023
Navigate Behavioral Health Payment Integrity Notification09/08/2023
Navigate Pharmacy Policy Updates October 202309/01/2023
Navigate Policy Updates September 202309/01/2023
Navigate September 2023 NIA Policies - Effective 11/1/2309/01/2023
Navigate Policy Updates September 202309/01/2023
Navigate Claims Processing Issues08/17/2023
Navigate Provider Revalidation – URGENT Action Required08/11/2023
Navigate Policy Updates August 202308/01/2023
Navigate GA MCD - June 2023 Versant Vision Policies Updates08/01/2023
Navigate Multi-Factor Authentication Implementation – UPDATE07/27/2023
Navigate New CPG Medical Record Audit Process07/21/2023
Navigate Incentive Limit for Social Determinants of Health Screening in Quality Enhancer Program07/06/2023
Navigate Multi-Factor Authentication Implementation07/05/2023
Navigate Announcing Georgia Pathways to Coverage Program07/01/2023
Navigate Pharmacy Policy Updates July 202307/01/2023
Navigate Public Health Emergency Ending – UPDATE06/22/2023
Navigate Revision - Autism Spectrum Disorder Policies and Procedures Manual06/09/2023
Navigate Q4 (2022) Avalon Quarterly Policy Updates06/01/2023
Navigate Q3 (2022) Avalon Quarterly Policy Updates06/01/2023
Navigate Policy Updates June 202306/01/2023
Navigate Updated Dental Provider Resources - Policy Clarifications and Revision05/30/2023
Navigate Prior Authorization Requirement for Non-Emergent NICU Transfers and Transports05/23/2023
Navigate Dental Providers – New Payor ID and Dental Claims Mailing Address05/22/2023
Navigate Pharmacy Policy Updates May 202305/01/2023
Navigate Policy Updates May 202305/01/2023
Navigate Public Health Emergency Ending - Updates to Benefits and Rates04/13/2023
Navigate Policy Updates April 202304/01/2023
Navigate UPDATE - 2023 Quality Enhancer Program for Providers Not Enrolled in a VBR03/27/2023
Navigate White Bagging Prohibited: State-Issued Directive 03/22/2023
Navigate GA MCD - January 2023 Versant Vision Policies Updates03/01/2023
UPDATE – Navigate Coordination of Healthcare Exchange of Information02/14/2023
Navigate Synagis Prior Authorization Resources Notification02/03/2023
Navigate Policy Updates February 202302/01/2023
Navigate FREE Training Available! Join Us for Our February Training of the Month02/01/2023
Navigate 2023 Pharmacy Network Change01/20/2023
Navigate Provider Alternative Format Request01/03/2023
Navigate Postpartum Extension01/03/2023
Navigate FREE Training Available! Join Us for Our January Training of the Month01/02/2023