Important information about utilization management
Our medical policies and UM criteria are online at providers.anthem.com/kentucky-provider/resources, or you can request a free copy of our UM criteria from our Medical Management department. Within seven calendar days of the date of denial, providers can discuss a UM denial decision with a physician reviewer by calling us toll-free at the number listed below.
We are staffed with clinical professionals who coordinate our members’ care and are available 24/7 to accept precertification requests. Secured voicemail is available during off-business hours. A clinical professional will return your call within the next business day. Our staff will identify themselves by name, title and being with Anthem when initiating or returning calls regarding UM issues.
You can submit precertification requests by:
- Calling us at 855-661-2028.
- Faxing to 800-964-3637.
- Submitting online at availity.com.*
Have questions about utilization decisions or the UM process?
Call our Clinical team at 855-661-2028 Monday through Friday from 7 a.m. to 7 p.m.
August 2021 Anthem Provider News - Kentucky