Kentucky
Provider Communications

Provider Spotlight

Oct 1, 2021

Important COVID-19 update: Prior authorization and other policy adjustments (updated October 1, 2021)

We recently updated prior authorization requirements for patient transfers from acute in-patient hospitals to skilled nursing facilities.


Articles Recent

Title Publication Category Date

Join the American Heart Association for a CME webinar on hypertension and diabetes disease management


Chronic disease management strategies for your patients with hypertension and diabetes

Date: Friday, October 8, 2021

Time: 12:00 p.m. ET

Clinical Quality CME Webinar Series Continues - Kentucky Administrative Oct 5, 2021

Important COVID-19 update: Prior authorization and other policy adjustments (updated October 1, 2021)

We recently updated prior authorization requirements for patient transfers from acute in-patient hospitals to skilled nursing facilities.
COVID-19 Information - Kentucky Administrative Oct 1, 2021

Clarification: Anthem’s enhanced claim edits for outpatient facility claims

October 2021 Anthem Provider News - Kentucky Administrative Oct 1, 2021

Specialty pharmacy updates are available - October 2021

October 2021 Anthem Provider News - Kentucky Pharmacy Oct 1, 2021

Pharmacy information available at anthem.com

October 2021 Anthem Provider News - Kentucky Pharmacy Oct 1, 2021

Medical policy and clinical guideline updates - October 2021

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

Reimbursement policy clarification: Claims requiring additional documentation - Facility

October 2021 Anthem Provider News - Kentucky Reimbursement Policies Oct 1, 2021

Clarification to reimbursement policy update: Virtual Visits - Professional and Facility

October 2021 Anthem Provider News - Kentucky Reimbursement Policies Oct 1, 2021

May 2021 medical policies and utilization management guidelines update

October 2021 Anthem Provider News - Kentucky Medicaid Oct 1, 2021

2021 affirmative statement concerning utilization management decisions

October 2021 Anthem Provider News - Kentucky Medicaid Oct 1, 2021

Appointment availability and after-hours access requirements

October 2021 Anthem Provider News - Kentucky Medicaid Oct 1, 2021

Keep up with Medicare news - October 2021

View these Medicare articles:
- 2021 affirmative statement concerning utilization management decisions
- May 2021 Medical Policies and Utilization Management Guidelines update
October 2021 Anthem Provider News - Kentucky Medicare Oct 1, 2021

Looking to earn CME credits? Register for these on-demand webinars!

October 2021 Anthem Provider News - Kentucky Administrative Oct 1, 2021

Federal Price Transparency and Consolidated Appropriations Act phase in new mandates beginning January 1, 2022

October 2021 Anthem Provider News - Kentucky Administrative Oct 1, 2021

Your recommendation is key to encouraging cancer screenings for your female patients

October 2021 Anthem Provider News - Kentucky Administrative Oct 1, 2021

Are you talking to ALL of your patients about breast cancer screenings?

October 2021 Anthem Provider News - Kentucky Administrative Oct 1, 2021

Good news! Non-payment remittance advice enhancements coming soon

October 2021 Anthem Provider News - Kentucky Administrative Oct 1, 2021

Clinical appeals

October 2021 Anthem Provider News - Kentucky Administrative Oct 1, 2021

Reminder: EnrollSafe, the new EFT enrollment portal for Anthem providers replacing CAQH Enrollhub effective November 1, 2021

October 2021 Anthem Provider News - Kentucky Digital Tools Oct 1, 2021

Procedure searches in Find Care

October 2021 Anthem Provider News - Kentucky Digital Tools Oct 1, 2021

Reminder: Updated AIM Musculoskeletal Program site of care reviews effective November 1, 2021

October 2021 Anthem Provider News - Kentucky Products & Programs Oct 1, 2021

New reimbursement policy: Sexually transmitted infections testing (Professional)

October 2021 Anthem Provider News - Kentucky Medicare Oct 1, 2021

Information about 2021 Special Needs Plans

October 2021 Anthem Provider News - Kentucky Medicare Oct 1, 2021

HEDIS medical record submission made easier with our Remote EMR Access Service

October 2021 Anthem Provider News - Kentucky Medicare Oct 1, 2021

New medical step therapy requirements

October 2021 Anthem Provider News - Kentucky Medicare Oct 1, 2021

Register today for the Exploring the Impact of Racial Trauma on the Health & Wellbeing of Children forum on September 29, 2021

Join us to hear from a diverse panel of experienced Motivo and Anthem professionals about the impact of racial trauma on the health and wellbeing on children and adolescents
Racial Trauma & Children - Kentucky Administrative Sep 15, 2021

National Accounts 2022 Pre-certification list

September 2021 Anthem Provider News - Kentucky Administrative Sep 1, 2021

Register now for our September CME webinars

September 2021 Anthem Provider News - Kentucky Administrative Sep 1, 2021

Statin therapy for patients with diabetes

September 2021 Anthem Provider News - Kentucky Administrative Sep 1, 2021

Six SIMPLE strategies to help increase medication adherence

September 2021 Anthem Provider News - Kentucky Administrative Sep 1, 2021

Cure for the common cold: Rest, fluids and this free prescription pad

September 2021 Anthem Provider News - Kentucky Administrative Sep 1, 2021

HEDIS® medical record submission made easier with our Remote EMR Access Service

September 2021 Anthem Provider News - Kentucky Administrative Sep 1, 2021

Get your payments faster when you sign up for electronic funds transfer

Introducing EnrollSafe, the new electronic funds transfer enrollment portal for Anthem providers – replacing CAQH Enrollhub effective November 1, 2021.
September 2021 Anthem Provider News - Kentucky Digital Tools Sep 1, 2021

Updates for specialty pharmacy are available - September 2021

September 2021 Anthem Provider News - Kentucky Pharmacy Sep 1, 2021

Updated guidance on prior authorization requirements for admissions to in-network skilled nursing facilities

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

Reimbursement policy update: Sexually transmitted infections testing - Professional

September 2021 Anthem Provider News - Kentucky Reimbursement Policies Sep 1, 2021

New reimbursement policy update: Inpatient Facility Transfers - Facility

September 2021 Anthem Provider News - Kentucky Reimbursement Policies Sep 1, 2021

Reimbursement policy update: Drug Screen Testing - Professional

September 2021 Anthem Provider News - Kentucky Reimbursement Policies Sep 1, 2021

Keep up with Medicaid news  - September 2021

View this Medicaid article:
- Clinical criteria web posting May 2020
September 2021 Anthem Provider News - Kentucky Medicaid Sep 1, 2021

Keep up with Medicare news - September 2021

View this Medicare article:
- Clinical criteria updates notification – May 2021

 

September 2021 Anthem Provider News - Kentucky Medicare Sep 1, 2021

Reimbursement Policy Update: DRG Inpatient Facility Transfers

September 2021 Anthem Provider News - Kentucky Medicare Sep 1, 2021

Utilization management authorization rule operations

September 2021 Anthem Provider News - Kentucky Medicare Sep 1, 2021

Prior authorization form notification

September 2021 Anthem Provider News - Kentucky Medicare Sep 1, 2021

Updated guidance on prior authorization requirements for admissions to in-network skilled nursing facilities

Updated guidance for admissions to in-network SNFs - Kentucky Medical Policy & Clinical Guidelines Aug 4, 2021

Information from Anthem for Care Providers about COVID-19 (updated August 2, 2021)

We recently updated information about coverage dates for telephonic-only care.
COVID-19 Information - Kentucky Administrative Aug 2, 2021

Register now for our August CME webinars

August 2021 Anthem Provider News - Kentucky Administrative Aug 1, 2021

Telehealth visits can impact after hospitalization follow-up care for mental illness

August 2021 Anthem Provider News - Kentucky Administrative Aug 1, 2021

Clearing up coding confusion for retinal eye exams (DRE)

August 2021 Anthem Provider News - Kentucky Administrative Aug 1, 2021

New! Schedule appointments online through Availity

August 2021 Anthem Provider News - Kentucky Digital Tools Aug 1, 2021

Submitting prior authorizations is getting easier

August 2021 Anthem Provider News - Kentucky Digital Tools Aug 1, 2021

Some requests to AIM may require documentation to support prior authorization

August 2021 Anthem Provider News - Kentucky Products & Programs Aug 1, 2021

Anthem to update formulary lists for commercial health plan pharmacy benefit effective October 1, 2021

August 2021 Anthem Provider News - Kentucky Pharmacy Aug 1, 2021

Updates for specialty pharmacy are available - August 2021

August 2021 Anthem Provider News - Kentucky Pharmacy Aug 1, 2021

Specialty dose rounding program for certain oncology medications

August 2021 Anthem Provider News - Kentucky Pharmacy Aug 1, 2021

Specialty dose rounding program for certain non-oncology medications beginning August 1, 2021

August 2021 Anthem Provider News - Kentucky Pharmacy Aug 1, 2021

Immune globulin adjusted body weight dosing program beginning August 1, 2021

August 2021 Anthem Provider News - Kentucky Pharmacy Aug 1, 2021

Pharmacy information available at anthem.com

August 2021 Anthem Provider News - Kentucky Pharmacy Aug 1, 2021

Update: AIM Musculoskeletal Program effective November 1, 2021 - Site of care reviews

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

Transition to AIM Specialty Health imaging of the heart clinical appropriateness guideline for computed tomography to detect coronary artery calcification

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

Reimbursement policy update: Virtual Visits (Professional and Facility)

August 2021 Anthem Provider News - Kentucky Reimbursement Policies Aug 1, 2021

Reimbursement policy update: Claims requiring additional documentation (Facility)

August 2021 Anthem Provider News - Kentucky Reimbursement Policies Aug 1, 2021

Reimbursement policy update: Distinct Procedural Service, Modifiers 59 and XE, XP, XS, & XU

August 2021 Anthem Provider News - Kentucky Reimbursement Policies Aug 1, 2021

Change in email submission of service requests for Federal Employee Program® members

August 2021 Anthem Provider News - Kentucky Federal Employee Plan (FEP) Aug 1, 2021

Medicaid News - August 2021

View these Medicaid articles:
- InterQual April 2021 revisions
- Prior authorization requirement changes effective October 1, 2021 – UM AROW 1837
August 2021 Anthem Provider News - Kentucky Medicaid Aug 1, 2021

March 2020 medical drug benefit clinical criteria updates

August 2021 Anthem Provider News - Kentucky Medicaid Aug 1, 2021

June 2020 medical drug benefit clinical criteria updates

August 2021 Anthem Provider News - Kentucky Medicaid Aug 1, 2021

New reimbursement policy: Modifier 90 Reference (Outside) Laboratory and Pass-Through Billing effective November 1, 2021

August 2021 Anthem Provider News - Kentucky Medicaid Aug 1, 2021

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

August 2021 Anthem Provider News - Kentucky Medicaid Aug 1, 2021

Keeping up with routine vaccination during COVID-19

August 2021 Anthem Provider News - Kentucky Medicaid Aug 1, 2021

Resources to support your diverse patient panel

August 2021 Anthem Provider News - Kentucky Medicaid Aug 1, 2021

Coding spotlight: mental disorders in childhood

August 2021 Anthem Provider News - Kentucky Medicaid Aug 1, 2021

Complex case management program

August 2021 Anthem Provider News - Kentucky Medicaid Aug 1, 2021

Important information about utilization management

August 2021 Anthem Provider News - Kentucky Medicaid Aug 1, 2021

Member rights’ and responsibilities statement

August 2021 Anthem Provider News - Kentucky Medicaid Aug 1, 2021

Medicare News - August 2021

View these Medicare articles:
- Infliximab Step Therapy - Effective 7/15/2021
- Prior authorization requirement changes effective October 1, 2021 – UM AROW 1907
August 2021 Anthem Provider News - Kentucky Medicare Aug 1, 2021

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

August 2021 Anthem Provider News - Kentucky Medicare Aug 1, 2021

Preventing claims denials: Shingles vaccine

August 2021 Anthem Provider News - Kentucky Medicare Aug 1, 2021

Register for upcoming August 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.

Motivating Patients to Adhere to Cervical Cancer Prevention and Screening Recommendations
Tuesday, August 3, 2021, 12:00 p.m. ET

10 Best Practices for Improving Pharmacy Quality Measures
Thursday, August 12, 2021, 1:00 p.m. or 3:00 p.m. ET

6 Ways to Improve Risk Adjustment Documentation Accuracy
Tuesday, August 17, 2021, 12:00 p.m. or 3:00 p.m. ET

Register Now!

Clinical Quality CME Webinar Series Continues - Kentucky Administrative Jul 29, 2021

Important update to provider UM reimbursement penalties and corresponding entry in Provider Manual

July 2021 Anthem Provider News - Kentucky Administrative Jul 1, 2021

Register now to learn strategies to help you and your practice improve clinical quality

July 2021 Anthem Provider News - Kentucky Administrative Jul 1, 2021

Timely receipt of primary payer’s EOB can help reduce timely filing denials for secondary claims

July 2021 Anthem Provider News - Kentucky Administrative Jul 1, 2021

Proper coding for in-home monitoring can make a measurable difference for INR

July 2021 Anthem Provider News - Kentucky Administrative Jul 1, 2021

Another mark of the pandemic: An increase in childhood obesity

July 2021 Anthem Provider News - Kentucky Administrative Jul 1, 2021

How to enroll in electronic fund transfer (EFT) for faster remittance

July 2021 Anthem Provider News - Kentucky Digital Tools Jul 1, 2021

Electronic claim response files

July 2021 Anthem Provider News - Kentucky Digital Tools Jul 1, 2021

Interactive Care Reviewer (ICR): New search option for cases submitted through ICR

July 2021 Anthem Provider News - Kentucky Digital Tools Jul 1, 2021

Company to retire Blue Precision program at the end of the year

July 2021 Anthem Provider News - Kentucky Products & Programs Jul 1, 2021

Reminder: Back Pain Guide program effective July 19, 2021

July 2021 Anthem Provider News - Kentucky Products & Programs Jul 1, 2021

Update: Site of care medical necessity reviews for long-acting colony-stimulating factors not implemented on June 1, 2021

July 2021 Anthem Provider News - Kentucky Pharmacy Jul 1, 2021

Updates for specialty pharmacy are available - July 2021

July 2021 Anthem Provider News - Kentucky Pharmacy Jul 1, 2021

Certain specialty medication prior authorization requests may require additional documentation

July 2021 Anthem Provider News - Kentucky Pharmacy Jul 1, 2021

Medical Policy and Clinical Guideline Updates - July 2021

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

Reminder: Updated AIM rehabilitative program effective August 1, 2021 - Site of service reviews

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

New reimbursement policy: Non-patient laboratory services - Facility

July 2021 Anthem Provider News - Kentucky Reimbursement Policies Jul 1, 2021

Reimbursement policy update: Consultations - Professional

July 2021 Anthem Provider News - Kentucky Reimbursement Policies Jul 1, 2021

Medicaid News - July 2021

View these Medicaid articles:
- Aspire Health for members in need of palliative care
- Clinical criteria updates notification December 2020
July 2021 Anthem Provider News - Kentucky Medicaid Jul 1, 2021

Let’s Vaccinate

July 2021 Anthem Provider News - Kentucky Medicaid Jul 1, 2021

What Matters Most: Improving the Patient Experience

July 2021 Anthem Provider News - Kentucky Medicaid Jul 1, 2021

Medicare News - July 2021

View these Medicare articles:
- Prior authorization requirement changes effective September 1, 2021 – UM Authorization Rule Operations Workgroup (AROW) Item 1845
- Provider notification for UM Authorization Rule Operations Workgroup (AROW) Item 1846
July 2021 Anthem Provider News - Kentucky Medicare Jul 1, 2021

Let’s Vaccinate

July 2021 Anthem Provider News - Kentucky Medicare Jul 1, 2021
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