Kentucky
Provider Communications

Provider Spotlight

Aug 10, 2020

Information from Anthem for Care Providers about COVID-19 (Updated August 10, 2020)

We recently updated FAQs with information about the use of modifier CS on claims related to evaluation for COVID-19 testing.


Articles Recent

Title Publication Category Date

Information from Anthem for Care Providers about COVID-19 (Updated August 10, 2020)

We recently updated FAQs with information about the use of modifier CS on claims related to evaluation for COVID-19 testing.
COVID-19 Information - Kentucky Administrative Aug 10, 2020

Anthem to update formulary lists for commercial health plan pharmacy benefit

August 2020 Anthem Provider News - Kentucky Pharmacy Aug 1, 2020

Voluntary site of care outreach for oncology checkpoint inhibitors beginning August 1, 2020

August 2020 Anthem Provider News - Kentucky Pharmacy Aug 1, 2020

Anthem prior authorization updates for specialty pharmacy are available - August 2020

August 2020 Anthem Provider News - Kentucky Pharmacy Aug 1, 2020

Pharmacy information available on anthem.com

August 2020 Anthem Provider News - Kentucky Pharmacy Aug 1, 2020

Provider contract and fee schedule notifications coming soon

August 2020 Anthem Provider News - Kentucky Administrative Aug 1, 2020

Resources to support diverse patients and communities

August 2020 Anthem Provider News - Kentucky Administrative Aug 1, 2020

Evaluation and management services correct coding (Professional)

August 2020 Anthem Provider News - Kentucky Administrative Aug 1, 2020

Migrate your EDI transactions to Availity today

August 2020 Anthem Provider News - Kentucky Administrative Aug 1, 2020

Electronic claims submission - Clinical Laboratory Improvement Amendments (CLIA)

August 2020 Anthem Provider News - Kentucky Administrative Aug 1, 2020

Anthem electronic attachments - X12 275 5010

August 2020 Anthem Provider News - Kentucky Administrative Aug 1, 2020

Coming soon: Enhance your prior authorization and inpatient admission and discharge notification via electronic and digital self-service for 2020

August 2020 Anthem Provider News - Kentucky Administrative Aug 1, 2020

Medical record standards

August 2020 Anthem Provider News - Kentucky Administrative Aug 1, 2020

Appropriate coding helps provide a comprehensive picture of patients’ health

August 2020 Anthem Provider News - Kentucky Administrative Aug 1, 2020

Medical policy and clinical guideline updates - August 2020

August 2020 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Aug 1, 2020

Expansion of AIM Musculoskeletal Program effective November 1, 2020

August 2020 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Aug 1, 2020

Reimbursement Policy Update: Claims requiring additional documentation (Facility)

August 2020 Anthem Provider News - Kentucky Reimbursement Policies Aug 1, 2020

Medicaid News - August 2020

View these Medicaid articles:
- InterQual 2020 update
- Appointment availability and after-hours access requirements
August 2020 Anthem Provider News - Kentucky Medicaid Aug 1, 2020

Medical drug benefit clinical criteria updates

August 2020 Anthem Provider News - Kentucky Medicaid Aug 1, 2020

Controlling high blood pressure (CBP)

August 2020 Anthem Provider News - Kentucky Medicaid Aug 1, 2020

Medicare News - August 2020

View these Medicare articles:
- Submit behavioral health authorizations via our online Interactive Care Reviewer (ICR) tool
- Updates to AIM musculoskeletal program clinical appropriateness guidelines
- Provider data update
- Waived copays, deductibles and coinsurance for CCM, complex CCM and TCM
- AIM Musculoskeletal program expansion
- New MCG Care Guidelines 24th edition
August 2020 Anthem Provider News - Kentucky Medicare Aug 1, 2020

Medical drug benefit clinical criteria updates

August 2020 Anthem Provider News - Kentucky Medicare Aug 1, 2020

2020 Medicare risk adjustment provider trainings

August 2020 Anthem Provider News - Kentucky Medicare Aug 1, 2020

Level of care medical necessity reviews for upper and lower endoscopy procedures begin October 1, 2020

July 2020 Anthem Provider News - Kentucky Products & Programs Jul 1, 2020

Updated coverage for HIV PrEP medications

July 2020 Anthem Provider News - Kentucky Pharmacy Jul 1, 2020

Anthem prior authorization updates for specialty pharmacy are available - July 2020

July 2020 Anthem Provider News - Kentucky Pharmacy Jul 1, 2020

Important change to prior authorization requests for inpatient hospital admissions

July 2020 Anthem Provider News - Kentucky Administrative Jul 1, 2020

Welcome to the Custom Learning Center in Availity

July 2020 Anthem Provider News - Kentucky Administrative Jul 1, 2020

Anthem Commercial Risk Adjustment (CRA) Reporting Update: 2020 Program Year Progression - What’s in it for you and your patients?

July 2020 Anthem Provider News - Kentucky Administrative Jul 1, 2020

New MCG 24th Edition Guidelines

July 2020 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Jul 1, 2020

Update: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and setting determination

July 2020 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Jul 1, 2020

Admission review process for Anthem Blue Cross and Blue Shield Federal Employee Program® (FEP) members

July 2020 Anthem Provider News - Kentucky Federal Employee Plan (FEP) Jul 1, 2020

Submit behavioral health authorizations via our online Interactive Care Reviewer tool

July 2020 Anthem Provider News - Kentucky Medicaid Jul 1, 2020

Coding spotlight: Provider’s guide to code social determinants of health

July 2020 Anthem Provider News - Kentucky Medicaid Jul 1, 2020

Coding spotlight: Provider’s guide to coding for cardiovascular conditions

July 2020 Anthem Provider News - Kentucky Medicaid Jul 1, 2020

Reminder: Mid-level practitioners are required to file using their NPI

July 2020 Anthem Provider News - Kentucky Medicaid Jul 1, 2020

Modifier use reminders

July 2020 Anthem Provider News - Kentucky Medicaid Jul 1, 2020

Medicare News - July 2020

View these Medicare articles:
- New behavioral health discharge call-in line
- Medical policies and clinical utilization management guidelines update
- Updates to AIM Specialty Health advanced imaging clinical appropriateness guidelines
- Transition to AIM rehabilitative services clinical appropriateness guidelines
- Modifier use reminders
July 2020 Anthem Provider News - Kentucky Medicare Jul 1, 2020

Prior authorization codes moving from AIM Specialty Health to Anthem Blue Cross and Blue Shield

July 2020 Anthem Provider News - Kentucky Medicare Jul 1, 2020

2020 affirmative statement concerning utilization management decisions

July 2020 Anthem Provider News - Kentucky Medicare Jul 1, 2020

Medical drug benefit clinical criteria updates

July 2020 Anthem Provider News - Kentucky Medicare Jul 1, 2020

In-Office Assessment Program

July 2020 Anthem Provider News - Kentucky Medicare Jul 1, 2020

2020 Special Needs Plans

July 2020 Anthem Provider News - Kentucky Medicare Jul 1, 2020

Webinar recording now available for providers on how to leverage telehealth to care for Behavioral Health patients during COVID-19 and beyond

Anthem hosted a provider webinar to share information and resources with Behavioral Health providers to assist with maximizing the telehealth experience.  Access the webinar recording to learn more about leveraging telehealth for behavioral health services.
COVID-19 Information - Kentucky Behavioral Health Jun 25, 2020

COVID-19 Update: Guidance for telehealth/telephonic care for Behavioral Health services (Updated June 9, 2020)

We are extending coverage for telehealth and telephonic-only care. Through September 30, 2020, Anthem will waive member cost shares for telehealth visits from in-network providers, including visits for mental health or substance use disorders.
COVID-19 Information - Kentucky Administrative Jun 9, 2020

Anthem prior authorization updates for specialty pharmacy are available - June 2020

June 2020 Anthem Provider News - Kentucky Pharmacy Jun 1, 2020

Reminder: Anthem requires National Drug Code for professional and facility outpatient claims effective June 15, 2020

June 2020 Anthem Provider News - Kentucky Pharmacy Jun 1, 2020

Pharmacy information available at anthem.com

June 2020 Anthem Provider News - Kentucky Pharmacy Jun 1, 2020

Updated Provider Manual now available

June 2020 Anthem Provider News - Kentucky Administrative Jun 1, 2020

Medical Policy and Clinical Guideline Updates - June 2020

June 2020 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Jun 1, 2020

Transition to AIM Rehabilitative Services Clinical Appropriateness Guidelines

June 2020 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Jun 1, 2020

New Reimbursement Policies: Nurse Practitioner and Physician Assistant Services (Professional)

June 2020 Anthem Provider News - Kentucky Reimbursement Policies Jun 1, 2020

Medical drug benefit Clinical Criteria updates - November 2019

June 2020 Anthem Provider News - Kentucky Medicaid Jun 1, 2020

Modifier use reminders

June 2020 Anthem Provider News - Kentucky Medicaid Jun 1, 2020

2020 affirmative statement concerning utilization management decisions

June 2020 Anthem Provider News - Kentucky Medicaid Jun 1, 2020

Follow-Up After Hospitalization for Mental Illness

June 2020 Anthem Provider News - Kentucky Medicaid Jun 1, 2020

Complex Case Management program

June 2020 Anthem Provider News - Kentucky Medicaid Jun 1, 2020

Important information about utilization management

June 2020 Anthem Provider News - Kentucky Medicaid Jun 1, 2020

Member Rights’ and Responsibilities Statement

June 2020 Anthem Provider News - Kentucky Medicaid Jun 1, 2020

A special thank you to Care Providers

Thank you for your tireless efforts in keeping our country healthy. For all you do, we would like to share a message of our gratitude.
COVID-19 Information - Kentucky Administrative Jun 1, 2020

Anthem enhances process for submitting behavioral health authorizations - now available

June 2020 Anthem Provider News - Kentucky Behavioral Health Jun 1, 2020

Quality Corner: Follow-Up after Hospitalization for Mental Illness

June 2020 Anthem Provider News - Kentucky Behavioral Health Jun 1, 2020

Anthem introduces lower cost Anthem Health Access Plans on June 1 in response to COVID-19 crisis

June 2020 Anthem Provider News - Kentucky Administrative Jun 1, 2020

Anthem Commercial Risk Adjustment (CRA) Program Update: Retrospective Program Begins; Prospective Program Continues

June 2020 Anthem Provider News - Kentucky Administrative Jun 1, 2020

Availity Portal Notification Center

June 2020 Anthem Provider News - Kentucky Administrative Jun 1, 2020

Quality Corner: CPT® Category II Codes - Collaborating for enhanced patient care

June 2020 Anthem Provider News - Kentucky Administrative Jun 1, 2020

REMINDER: AIM Rehabilitative Program Pediatric Exclusions

June 2020 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Jun 1, 2020

Medicare News - June 2020

View these Medicare articles:
- Acquisition of Beacon Health Options
- MCG care guidelines – 24th edition
June 2020 Anthem Provider News - Kentucky Medicare Jun 1, 2020

2020 Medicare risk adjustment provider trainings

June 2020 Anthem Provider News - Kentucky Medicare Jun 1, 2020

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

June 2020 Anthem Provider News - Kentucky Medicare Jun 1, 2020

Anthem Blue Cross and Blue Shield (Anthem) working with Optum to collect medical records for risk adjustment

June 2020 Anthem Provider News - Kentucky Medicare Jun 1, 2020

Modifier use reminders

June 2020 Anthem Provider News - Kentucky Medicare Jun 1, 2020

Diabetes HbA1c < 8 HEDIS guidance

June 2020 Anthem Provider News - Kentucky Medicare Jun 1, 2020

Anthem waives cost share for COVID-19 treatment (Updated May 29, 2020)

Effective April 1, we expanded coverage for our members undergoing treatment related to a COVID-19 diagnosis, which covers the waiver of cost shares for COVID-19 treatment received through December 31, 2020.
COVID-19 Information - Kentucky Administrative May 29, 2020

Important COVID-19 update: Prior authorization and other policy adjustments (Updated May 29, 2020)

We’ve updated guidance about prior authorization requirements and other policy adjustments in response to unprecedented demands on health care providers.
COVID-19 Information - Kentucky Administrative May 29, 2020

Introducing lower cost Anthem Health Access Plans on June 1 in response to COVID-19 crisis

Beginning June 1, 2020, Anthem is introducing our Anthem Health Access Plans for certain large group employers currently enrolled in our commercial lines of business only.
COVID-19 Information - Kentucky Administrative May 26, 2020

Webinar recording now available for network providers on SBA loans and other federal relief programs in response to COVID-19 (Updated May 1, 2020)

Anthem hosted a provider webinar to share information and resources with its network providers regarding opportunities providers have to access loans through the U.S Small Business Administration (SBA) and other federal programs in response to the economic impact of COVID-19. Access the webinar recording using the password “health” to learn more about federal financial relief for providers.
COVID-19 Information - Kentucky Administrative May 1, 2020

Anthem prior authorization updates for specialty pharmacy are available - May 2020

May 2020 Anthem Provider News - Kentucky Pharmacy May 1, 2020

COVID-19 information repository for Anthem Care Providers

May 2020 Anthem Provider News - Kentucky Administrative May 1, 2020

Updates to AIM Advanced Imaging Clinical Appropriateness Guideline

May 2020 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline

May 2020 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM MSK Interventional Pain Management Clinical Appropriateness Guideline

May 2020 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM Musculoskeletal Program Joint Surgery Clinical Appropriateness Guidelines

May 2020 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines May 1, 2020

Reimbursement Policy Update: Claims requiring additional documentation (Facility)

May 2020 Anthem Provider News - Kentucky Reimbursement Policies May 1, 2020

Acquisition of Beacon Health Options

May 2020 Anthem Provider News - Kentucky Medicaid May 1, 2020

Prior authorization requirements: New 2020 codes for coverage and precertification

May 2020 Anthem Provider News - Kentucky Medicaid May 1, 2020

Reimbursement Policy Update: Unlisted, Unspecified or Miscellaneous Codes

May 2020 Anthem Provider News - Kentucky Medicaid May 1, 2020

Medical drug benefit Clinical Criteria updates

May 2020 Anthem Provider News - Kentucky Medicaid May 1, 2020

Anthem Commercial Risk Adjustment (CRA) Prospective Program Update: Assessing Your Patients for Risk Adjustable Conditions

May 2020 Anthem Provider News - Kentucky Administrative May 1, 2020

Quality Corner: Diabetes HbA1c<8 HEDIS Guidance

May 2020 Anthem Provider News - Kentucky Administrative May 1, 2020

Reminder about system updates

May 2020 Anthem Provider News - Kentucky Reimbursement Policies May 1, 2020

Medicare News - May 2020

View these Medicare articles:
- Prior Authorization requirements
- New behavioral health Medicare Advantage individual and Group Retiree Solutions provider fax
May 2020 Anthem Provider News - Kentucky Medicare May 1, 2020

Reimbursement Policy Update: Unlisted, Unspecified or Miscellaneous Codes

May 2020 Anthem Provider News - Kentucky Medicare May 1, 2020

Multi-dose packaging

May 2020 Anthem Provider News - Kentucky Medicare May 1, 2020

Federal Resources Available for Care Providers and Employers in the Federal CARES Act

During the COVID-19 crisis, care providers are working to keep the country running while navigating the financial impact it is having on them. To help care providers navigate the resources available to them, Anthem has compiled information on programs we have learned about that could provide additional financial relief during this crisis.
COVID-19 Information - Kentucky Administrative Apr 10, 2020

Information from Anthem for Care Providers about COVID-19

*Please bookmark/add to favorites Provider News Home for the latest information about COVID-19.
April 2020 Anthem Provider News - Kentucky Administrative Apr 1, 2020

Anthem prior authorization updates for specialty pharmacy are available - April 2020

April 2020 Anthem Provider News - Kentucky Pharmacy Apr 1, 2020

MCG Care Guidelines 24th Edition

April 2020 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Apr 1, 2020

UPDATE: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements

April 2020 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Apr 1, 2020

Medicaid News - April 2020

View this Medicaid notice:
- New specialty pharmacy medical step therapy requirements
April 2020 Anthem Provider News - Kentucky Medicaid Apr 1, 2020
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