Kentucky
Provider Communications

Articles Category: State & Federal

Title Publication Category Date

2022 FEP benefit information available online

January 2022 Anthem Provider News - Kentucky Federal Employee Plan (FEP) Jan 1, 2022

Keep up with Medicaid News - January 2022

- New department for Medicaid services MAP form available for providers
- Cancer Care Navigator
- Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines
- Medical Policies and Clinical Utilization Management Guidelines update
- Specialty pharmacy site of care
- Prior authorization updates for medications billed under the medical benefit
January 2022 Anthem Provider News - Kentucky Medicaid Jan 1, 2022

Unspecified diagnosis reminder

January 2022 Anthem Provider News - Kentucky Medicaid Jan 1, 2022

Keep up with Medicare News - January 2022

- AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines update
- Medical step therapy updates
- Anthem expands specialty pharmacy precertification list
January 2022 Anthem Provider News - Kentucky Medicare Jan 1, 2022

Important update on Botox® for Anthem Medicare members

January 2022 Anthem Provider News - Kentucky Medicare Jan 1, 2022

Reducing the burden of medical record review and improving health outcomes with HEDIS ECDS reporting

January 2022 Anthem Provider News - Kentucky Medicare Jan 1, 2022

Keep up with Medicaid News - December 2021

  • Prior authorization updates for specialty pharmacy effective December 1, 2021
  • Prior authorization updates for specialty pharmacy effective January 1, 2022
December 2021 Anthem Provider News - Kentucky Medicaid Dec 1, 2021

COVID-19 Vaccine Provider Incentive program

December 2021 Anthem Provider News - Kentucky Medicaid Dec 1, 2021

Submitting prior authorizations is getting easier

December 2021 Anthem Provider News - Kentucky Medicaid Dec 1, 2021

Good news: Non-payment remittance advice enhancements are here

December 2021 Anthem Provider News - Kentucky Medicaid Dec 1, 2021

HEDIS measures: Follow-Up After ED Visits for Mental Illness and Alcohol and Other Drug Abuse or Dependence

December 2021 Anthem Provider News - Kentucky Medicaid Dec 1, 2021

4 things you can do to encourage cancer screenings for your female patients

December 2021 Anthem Provider News - Kentucky Medicaid Dec 1, 2021

2022 Medicare Advantage service area and benefit updates

December 2021 Anthem Provider News - Kentucky Medicare Dec 1, 2021

Submitting prior authorizations is getting easier

December 2021 Anthem Provider News - Kentucky Medicare Dec 1, 2021

Keep up with Medicare News - December 2021

  • Updates to AIM Specialty Health musculoskeletal interventional pain management clinical appropriateness guideline
  • Medical drug benefit clinical criteria updates
  • Protocol for providers serving members with hearing aid coverage administered by Hearing Care Solutions
  • New York City Medicare Advantage announcement
  • Medical policies and clinical utilization management guidelines update
  • Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines (WI only)
December 2021 Anthem Provider News - Kentucky Medicare Dec 1, 2021

Adjudicating claims for COVID-19 vaccines, their administration and COVID-19 monoclonal antibodies

December 2021 Anthem Provider News - Kentucky Medicare Dec 1, 2021

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

December 2021 Anthem Provider News - Kentucky Medicare Dec 1, 2021

Reimbursement policy update: Drug screen testing

December 2021 Anthem Provider News - Kentucky Medicare Dec 1, 2021

Good news: Non-payment remittance advice enhancements are here

December 2021 Anthem Provider News - Kentucky Medicare Dec 1, 2021

Somatus is your resource for kidney care management

December 2021 Anthem Provider News - Kentucky Medicare Dec 1, 2021

Keep up with Medicaid News - November 2021

View these Medicaid articles:
- March 2021 Medical drug benefit Clinical Criteria updates
- May 2021 Medical drug benefit Clinical Criteria updates
November 2021 Anthem Provider News - Kentucky Medicaid Nov 1, 2021

Electronic data interchange process

November 2021 Anthem Provider News - Kentucky Medicaid Nov 1, 2021

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

November 2021 Anthem Provider News - Kentucky Medicaid Nov 1, 2021

Diabetes testing and screening HEDIS measures

November 2021 Anthem Provider News - Kentucky Medicaid Nov 1, 2021

Keep up with Medicare News - November 2021

View these Medicare articles:
- Anthem expands specialty pharmacy prior authorization list
November 2021 Anthem Provider News - Kentucky Medicare Nov 1, 2021

Anthem offering Advance Medical Directives program for 2022

November 2021 Anthem Provider News - Kentucky Medicare Nov 1, 2021

Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines

November 2021 Anthem Provider News - Kentucky Medicare Nov 1, 2021

New York City Medicare Advantage announcement

November 2021 Anthem Provider News - Kentucky Medicare Nov 1, 2021

Clinical criteria updates

November 2021 Anthem Provider News - Kentucky Medicare Nov 1, 2021

Electronic data interchange process

November 2021 Anthem Provider News - Kentucky Medicare Nov 1, 2021

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

November 2021 Anthem Provider News - Kentucky Medicare Nov 1, 2021

New Medicare Advantage plan will have access to BlueCross BlueShield Medicare Advantage PPO Network Sharing providers nationally

Effective January 1, 2022, approximately 240,000 Medicare-eligible City of New York retirees across the United States will transition to Retiree Health Alliance’s NYC Medicare Advantage Plus plan and have access to BlueCross BlueShield Medicare Advantage PPO Network Sharing. Read important information about this change in the New York City Medicare Advantage announcement.

New 240k member Medicare Advantage Group Retiree PPO plan Medicare Oct 19, 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

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

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

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

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

Medical drug benefit clinical criteria updates

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

Prior authorization requirement changes for codes A0426 and A0428 effective October 1, 2021

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

New reimbursement policy: Modifier 90: Reference (outside) laboratory and pass-through billing

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

DEXA bone scan criteria for the Federal Employee Program®

June 2021 Anthem Provider News - Kentucky Federal Employee Plan (FEP) Jun 1, 2021

Medicaid News - June 2021

View these Medicaid articles:
- Maximizing efficient, high quality COVID-19 screenings
- Medical drug benefit clinical criteria updates
- Updates to the AIM Advanced Imaging clinical appropriateness guidelines
June 2021 Anthem Provider News - Kentucky Medicaid Jun 1, 2021

Provider education program survey: Your Voice Counts

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

Important Crib and Car Seat Program update

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

MCG Care Guidelines 25th Edition

June 2021 Anthem Provider News - Kentucky Medicare 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

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

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

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

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

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
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