Kentucky
Provider Communications

Articles

Title Publication Category Date

New Back Pain Management Program effective July 19, 2021

June 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Jun 1, 2021

Reimbursement policy update: Outpatient facility claim edits

June 2021 Anthem Provider News - Kentucky Reimbursement Policies Jun 1, 2021

Medicare News - June 2021

View these Medicare articles:
- Anthem working with Optum to collect medical records for risk adjustment
- Medical drug benefit clinical criteria updates
- Updates to the AIM advanced imaging clinical appropriateness guidelines
June 2021 Anthem Provider News - Kentucky Medicare Jun 1, 2021

Medical policies and clinical utilization management guidelines update

June 2021 Anthem Provider News - Kentucky Medicare Jun 1, 2021

Reminders for Medicare Advantage Group Retiree PPO plans and National Access Plus FAQ

June 2021 Anthem Provider News - Kentucky Medicare Jun 1, 2021

Reimbursement policy reminder: Inpatient readmissions

June 2021 Anthem Provider News - Kentucky Medicare Jun 1, 2021

Register for upcoming CME webinars

Join us in a new CME webinar series as we share practices and success stories to overcoming barriers in achieving clinical quality goals, attaining better patient outcomes and improving Stars ratings.

5 Strategies to Improve Your Quality Measures - June 10th, 12 p.m. or 3 p.m. ET
7 Ways to Enhance Your Patients’ Experience - June 17th, 12 p.m. or 3 p.m. ET

Register now!


Clinical Quality CME Webinar Series - Kentucky Administrative May 27, 2021

Register today for the In Pursuit of Racial Equity: Deconstructing Bias forum hosted by Anthem and Motivo on June 9, 2021

Join us to hear from a diverse panel of experienced Motivo and Anthem professionals about racial equity and implicit bias.
Deconstructing Bias Forum Invitation - Kentucky Administrative May 21, 2021

Specialty pharmacy prior authorization update - Certain drugs for treatment of ocular conditions continue to require prior authorization

May 2021 Anthem Provider News - Kentucky Pharmacy May 1, 2021

Updates for specialty pharmacy are available - May 2021

May 2021 Anthem Provider News - Kentucky Pharmacy May 1, 2021

Colonoscopies following a positive stool- or blood-based test are screening tests for Kentucky members

May 2021 Anthem Provider News - Kentucky Administrative May 1, 2021

Updated Provider Manual now available

May 2021 Anthem Provider News - Kentucky Administrative May 1, 2021

Resources to support diverse patients and communities

May 2021 Anthem Provider News - Kentucky Administrative May 1, 2021

Referring to network DME providers for negative pressure wound therapy helps members save on out-of-pocket costs

May 2021 Anthem Provider News - Kentucky Administrative May 1, 2021

2021 Affirmative statement regarding utilization management decisions

May 2021 Anthem Provider News - Kentucky Administrative May 1, 2021

A helpful and complete guide to covered well-child visits

May 2021 Anthem Provider News - Kentucky Administrative May 1, 2021

May is National High Blood Pressure Education Month

May 2021 Anthem Provider News - Kentucky Administrative May 1, 2021

Digital online scheduling feature now available in the Availity Portal

May 2021 Anthem Provider News - Kentucky Administrative May 1, 2021

Provider bulletins for medical and itemized bill attachments: Electronic solutions at your fingertips

May 2021 Anthem Provider News - Kentucky Administrative May 1, 2021

Sending larger digital attachments through Availity

May 2021 Anthem Provider News - Kentucky Administrative May 1, 2021

New prior authorization requirement: Kidney transplantation

May 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines May 1, 2021

Update to AIM Specialty Health oncologic imaging clinical appropriateness guidelines

May 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines May 1, 2021

Updated AIM rehabilitative program effective August 1, 2021 - Initial evaluations and site of service reviews

May 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines May 1, 2021

Modification to voluntary Cancer Care Quality Program (CCQP) enhanced reimbursement to begin July 1, 2021

May 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines May 1, 2021

Reimbursement policy update: Claims Requiring Additional Documentation - Facility

May 2021 Anthem Provider News - Kentucky Reimbursement Policies May 1, 2021

Reimbursement policy reminder: Readmission - Facility

May 2021 Anthem Provider News - Kentucky Reimbursement Policies May 1, 2021

Reimbursement policy update: Frequency editing - Professional

May 2021 Anthem Provider News - Kentucky Reimbursement Policies May 1, 2021

Medicaid news - May 2021

View these Medicaid articles:
- Clinical criteria updates notification November 2020
- Update to claim filing limit
May 2021 Anthem Provider News - Kentucky Medicaid May 1, 2021

Metabolic monitoring and diabetes screening measures for those on antipsychotics medications

May 2021 Anthem Provider News - Kentucky Medicaid May 1, 2021

Continuing medical education and continuing education unit opportunities

May 2021 Anthem Provider News - Kentucky Medicaid May 1, 2021

Maximizing efficient, high quality COVID-19 screenings

May 2021 Anthem Provider News - Kentucky Medicare May 1, 2021

Sign up to receive email from Anthem Blue Cross and Blue Shield Medicaid

May 2021 Anthem Provider News - Kentucky Medicaid May 1, 2021

Keep up with Medicare news - May 2021

View these Medicare articles:
- Anthem working with Optum to collect medical records for Medicare Risk Adjustment (MRA)
- Helping our senior members
- Updates to the AIM Specialty Health musculoskeletal program clinical appropriateness guidelines
May 2021 Anthem Provider News - Kentucky Medicare May 1, 2021

Update for specialty pharmacy: Change in clinical criteria

April 2021 Provider News - Specialty pharmacy update: Change in clinical criteria - Kentucky Pharmacy Apr 14, 2021

Updates for specialty pharmacy are available - April 2021

April 2021 Anthem Provider News - Kentucky Pharmacy Apr 1, 2021

Pharmacy information available at anthem.com

April 2021 Anthem Provider News - Kentucky Pharmacy Apr 1, 2021

Does your practice offer telehealth services? Let us know!

April 2021 Anthem Provider News - Kentucky Administrative Apr 1, 2021

Information Center - Access important policies, forms and helpful resources

April 2021 Anthem Provider News - Kentucky Administrative Apr 1, 2021

Understanding Availity roles for electronic data interchange (EDI)

April 2021 Anthem Provider News - Kentucky Administrative Apr 1, 2021

Make the change to digital authorization/referral and hospital admission notifications using EDI

April 2021 Anthem Provider News - Kentucky Administrative Apr 1, 2021

Attention facilities: Sending admission, discharge and transfer data results in improved care management for patients

April 2021 Anthem Provider News - Kentucky Administrative Apr 1, 2021

Chat directly with a prior authorization specialist

April 2021 Anthem Provider News - Kentucky Administrative Apr 1, 2021

Keeping up with routine vaccination during COVID-19

April 2021 Anthem Provider News - Kentucky Administrative Apr 1, 2021

Interactive bilingual website taking action for our health

Exclusively developed for the Latino Community
April 2021 Anthem Provider News - Kentucky Administrative Apr 1, 2021

Join Anthem in talking about racism and its impact on health

April 2021 Anthem Provider News - Kentucky Administrative Apr 1, 2021

Medical policy and clinical guideline updates - April 2021

April 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Apr 1, 2021

Update: Clinical guideline adoption postponed

April 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Apr 1, 2021

MCG Care Guidelines 25th Edition available

April 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Apr 1, 2021

Maximizing efficient, high quality COVID-19 screenings

COVID-19 Information - Kentucky Medical Policy & Clinical Guidelines Apr 1, 2021

Update for Commercial providers: AIM sleep program CPT code E1399, NOC: Durable medical equipment, miscellaneous

April 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Apr 1, 2021

HEDIS 2021 Federal Employee Program® medical record request requirements

April 2021 Anthem Provider News - Kentucky Federal Employee Plan (FEP) Apr 1, 2021

Medical drug benefit clinical criteria updates - April 2021

April 2021 Anthem Provider News - Kentucky Medicaid Apr 1, 2021

Access to more claim denial information is now self-service

April 2021 Anthem Provider News - Kentucky Medicaid Apr 1, 2021

Does your practice offer telehealth services? Let us know!

April 2021 Anthem Provider News - Kentucky Medicare Apr 1, 2021

Access to more claim denial information is now self-service

April 2021 Anthem Provider News - Kentucky Medicare Apr 1, 2021

In-Office Assessment program

April 2021 Anthem Provider News - Kentucky Medicare Apr 1, 2021

Oncology dose reduction program beginning July 1, 2021

April 2021 Anthem Provider News - Kentucky Medicare Apr 1, 2021

Clinical criteria updates notification - November 2020

April 2021 Anthem Provider News - Kentucky Medicare Apr 1, 2021

Clinical criteria updates notification - December 2020

April 2021 Anthem Provider News - Kentucky Medicare Apr 1, 2021

The health of millennials: Trends in behavioral health conditions

April 2021 Anthem Provider News - Kentucky Behavioral Health Apr 1, 2021

Correction: Updated formulary lists for commercial health plan pharmacy benefit effective April 1, 2021

April 2021 Anthem Provider News - Kentucky Pharmacy Apr 1, 2021

Some HIV medication combinations may require prior authorization

March 2021 Anthem Provider News - Kentucky Pharmacy Mar 1, 2021

Medical attachment capability now includes itemized bills and more!

March 2021 Anthem Provider News - Kentucky Administrative Mar 1, 2021

Update: Notice of changes to the AIM Small Joint Surgery guideline

March 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Mar 1, 2021

Claims editing update for ICD-10-CM Excludes 1 notes

March 2021 Anthem Provider News - Kentucky Reimbursement Policies Mar 1, 2021

Medicare News - March 2021

View these Medicare articles:
- MCG Care Guidelines 24th edition customization
- DME checklist of information needed from providers
March 2021 Anthem Provider News - Kentucky Medicare Mar 1, 2021

New provider directory indicator for telehealth services

March 2021 Anthem Provider News - Kentucky Medicare Mar 1, 2021

Medical policies and clinical utilization management guidelines update

March 2021 Anthem Provider News - Kentucky Medicare Mar 1, 2021

Site of Care medical necessity reviews for long-acting colony-stimulating factors begin June 1, 2021

March 2021 Anthem Provider News - Kentucky Pharmacy Mar 1, 2021

Updates for specialty pharmacy are available - March 2021

March 2021 Anthem Provider News - Kentucky Pharmacy Mar 1, 2021

Availity Portal eligibility and benefits provides both additional benefit notes and digital member ID cards

March 2021 Anthem Provider News - Kentucky Medicaid Mar 1, 2021

Prior authorization required for radiotherapies and radioimmunotherapies effective March 1, 2021

March 2021 Anthem Provider News - Kentucky Medicaid Mar 1, 2021

Prior authorization requirement changes effective April 1, 2021

March 2021 Anthem Provider News - Kentucky Medicaid Mar 1, 2021

Anthem to update formulary lists for commercial health plan pharmacy benefit

February 2021 Anthem Provider News - Kentucky Pharmacy Feb 1, 2021

Prior authorization updates for specialty pharmacy are available - February 2021

February 2021 Anthem Provider News - Kentucky Pharmacy Feb 1, 2021

Pharmacy information available at anthem.com

February 2021 Anthem Provider News - Kentucky Pharmacy Feb 1, 2021

New provider directory indicator for telehealth services

February 2021 Anthem Provider News - Kentucky Administrative Feb 1, 2021

New Anthem utilization management tool now available on Availity: Authorization Rules Lookup tool

February 2021 Anthem Provider News - Kentucky Administrative Feb 1, 2021

Medical Policy and Clinical Guideline Updates - February 2021

February 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Feb 1, 2021

Reimbursement policy update: Emergency Room Transfers - Facility

February 2021 Anthem Provider News - Kentucky Reimbursement Policies Feb 1, 2021

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services - Facility

February 2021 Anthem Provider News - Kentucky Reimbursement Policies Feb 1, 2021

Medicaid News - February 2021

View these Medicaid articles:
- InterQual 2020.1 update
- New specialty pharmacy medical step therapy requirements-1
- New specialty pharmacy medical step therapy requirements-2
- Updates to AIM Clinical Appropriateness Guidelines for Advanced Imaging
- Sign up to receive email from Anthem Blue Cross and Blue Shield Medicaid
February 2021 Anthem Provider News - Kentucky Medicaid Feb 1, 2021

Medical drug benefit clinical criteria updates - February 2021

February 2021 Anthem Provider News - Kentucky Medicaid Feb 1, 2021

CAHPS® survey

February 2021 Anthem Provider News - Kentucky Medicaid Feb 1, 2021

HEDIS Measurement Year 2020: Medicaid summary of changes from NCQA

February 2021 Anthem Provider News - Kentucky Medicaid Feb 1, 2021

FDA approvals and expedited pathways used - new molecular entities (NMEs)

February 2021 Anthem Provider News - Kentucky Medicaid Feb 1, 2021

PN for UM AROW Item 1330

February 2021 Anthem Provider News - Kentucky Medicare Feb 1, 2021

Medical drug benefit clinical criteria updates - February 2021

February 2021 Anthem Provider News - Kentucky Medicare Feb 1, 2021

Updates to AIM Clinical Appropriateness Guidelines for Advanced Imaging

February 2021 Anthem Provider News - Kentucky Medicare Feb 1, 2021

Register today for The Road to Allyship Forum hosted by Anthem and Motivo on February 3, 2021

Join us to hear from a diverse panel of experienced Motivo and Anthem professionals about racial equity and the importance of allies.
The Road to Allyship Forum Invitation Administrative Jan 21, 2021

COVID-19 Update: Guidance for telehealth/telephonic care for Behavioral Health services (Updated January 8, 2021)

We’ve updated information about coverage for telephonic-only care.
COVID-19 Information - Kentucky Administrative Jan 8, 2021

Prior authorization updates for specialty pharmacy are available - January 2021

January 2021 Anthem Provider News - Kentucky Pharmacy Jan 1, 2021

Medical Policy and Clinical Guideline Updates - January 2021

January 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Jan 1, 2021

MCG Care Guidelines 24th Edition Customization

January 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Jan 1, 2021

Reimbursement policy update: Multiple diagnostic imaging procedures - Professional

January 2021 Anthem Provider News - Kentucky Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Frequency editing - Professional

January 2021 Anthem Provider News - Kentucky Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Guidelines for reporting timed units for physical medicine and rehabilitation - Professional

January 2021 Anthem Provider News - Kentucky Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Modifier Rules - Professional

January 2021 Anthem Provider News - Kentucky Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Unit frequency maximum for drugs and biologicals - Professional

January 2021 Anthem Provider News - Kentucky Reimbursement Policies Jan 1, 2021

IngenioRx introduces new pharmacy network in 2021

January 2021 Anthem Provider News - Kentucky Pharmacy Jan 1, 2021
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