Kentucky
Provider Communications

Articles Category: State & Federal / Medicare

Title Publication Category Date

2019 Medicare Advantage individual benefits and formularies

December 2018 Anthem Kentucky Provider Newsletter Medicare Dec 1, 2018

2020 affirmative statement concerning utilization management decisions

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

2020 Medicare risk adjustment provider trainings

January 2020 Anthem Provider News - Kentucky Medicare Jan 1, 2020

2020 Medicare risk adjustment provider trainings

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

2020 Medicare risk adjustment provider trainings

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

2020 Medicare risk adjustment provider trainings

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

2020 Medicare risk adjustment provider trainings

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

2020 Special Needs Plans

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

2021 Medicare Advantage individual benefits and formularies

December 2020 Anthem Provider News - Kentucky Medicare Dec 1, 2020

Access to more claim denial information is now self-service

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

AIM Specialty Health programs may require documentation

August 2019 Anthem Provider News - Kentucky Medicare Aug 1, 2019

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

Anthem eye refraction and routine eye exam billing information

February 2019 Anthem Kentucky Provider Newsletter Medicare Feb 1, 2019

Anthem offers risk adjustment and documentation training

January 2019 Anthem Kentucky Provider Newsletter Medicare Jan 1, 2019

Anthem transitions MA back pain management and cardiology UM programs from OrthoNet to AIM

October 2018 Anthem Kentucky Provider Newsletter Medicare Sep 28, 2018

Aspire Telehealth Palliative Care program

October 2019 Anthem Provider News - Kentucky Medicare Oct 1, 2019

August 2019 Medical drug benefit Clinical Criteria updates

January 2020 Anthem Provider News - Kentucky Medicare Jan 1, 2020

Blue Cross and Blue Shield Association mandate about Medicare Advantage care management and provider engagement

November 2019 Anthem Provider News - Kentucky Medicare Nov 1, 2019

Change to 835 ERA for all D-SNP MA members for 2019

March 2019 Anthem Provider Newsletter - Kentucky Medicare Mar 1, 2019

Changes to prior authorization (PA) requirements

September 2019 Anthem Provider News - Kentucky Medicare Sep 1, 2019

Clinical Criteria updates

September 2019 Anthem Provider News - Kentucky Medicare Sep 1, 2019

Clinical criteria updates for specialty pharmacy

March 2019 Anthem Provider Newsletter - Kentucky Medicare Mar 1, 2019

Clinical criteria updates notification - December 2020

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

CMS Medicare Preclusion List effective April 1, 2019

December 2018 Anthem Kentucky Provider Newsletter Medicare Dec 1, 2018

CMS reminder: expedited/urgent requests

November 2019 Anthem Provider News - Kentucky Medicare Nov 1, 2019

Coming soon: Electronic attachments

September 2019 Anthem Provider News - Kentucky Medicare Sep 1, 2019

Coming soon: Reimbursement for select HEDIS-related CPT II codes for Medicare Advantage members

April 2019 Anthem Provider Newsletter - Kentucky Medicare Apr 1, 2019

Complex discharge planning

March 2020 Anthem Provider News - Kentucky Medicare Mar 1, 2020

COVID-19 information from Anthem Blue Cross and Blue Shield

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

Customizations to the 23rd edition of the MCG Care Guidelines

September 2019 Anthem Provider News - Kentucky Medicare Sep 1, 2019

Diabetes HbA1c < 8 HEDIS guidance

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

Digital transactions cut administrative tasks in half

December 2020 Anthem Provider News - Kentucky Medicare Dec 1, 2020

Digital transactions cut administrative tasks in half

November 2020 Anthem Provider News - Kentucky Medicare Nov 1, 2020

Does your practice offer telehealth services? Let us know!

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

Dual Eligible Special Needs (D-SNP) Plans - provider training required

March 2019 Anthem Provider Newsletter - Kentucky Medicare Mar 1, 2019

Electric Boat offers Medicare Advantage options

January 2020 Anthem Provider News - Kentucky Medicare Jan 1, 2020

Electronic claim payment reconsideration

July 2019 Anthem Provider News - Kentucky Medicare Jul 1, 2019

Electronic submission is preferred method for requesting pharmacy prior authorization

November 2019 Anthem Provider News - Kentucky Medicare Nov 1, 2019

FDA approvals and expedited pathways used - new molecular entities

November 2020 Anthem Provider News - Kentucky Medicare Nov 1, 2020

Genetic testing prior authorization by ordering physician helps ensure accurate lab payment

October 2018 Anthem Kentucky Provider Newsletter Medicare Sep 28, 2018

Group Retiree Solutions Kentucky and Ohio HMO Medicare Advantage plans

December 2019 Anthem Provider News - Kentucky Medicare Dec 1, 2019

Healthcare Quality Patient Assessment Form and Patient Assessment Form

January 2020 Anthem Provider News - Kentucky Medicare Jan 1, 2020

Help protect your patients by providing medical ID protection - best practices

January 2020 Anthem Provider News - Kentucky Medicare Jan 1, 2020

Home health billing guidelines for contracted providers

July 2019 Anthem Provider News - Kentucky Medicare Jul 1, 2019

In-Office Assessment program

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

In-Office Assessment Program

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

Individual Medicare plans move compound drugs off formulary beginning January 1, 2019

December 2018 Anthem Kentucky Provider Newsletter Medicare Dec 1, 2018

Introducing a new clinical criteria web page for injectable, infused or implanted drugs covered under the medical benefit

March 2019 Anthem Provider Newsletter - Kentucky Medicare Mar 1, 2019

Introducing ConcertoHealth

January 2020 Anthem Provider News - Kentucky Medicare Jan 1, 2020

June 2019 Medical Policies and Clinical Utilization Management Guidelines update

October 2019 Anthem Provider News - Kentucky Medicare Oct 1, 2019

Keep up with Medicare news

October 2018 Anthem Kentucky Provider Newsletter Medicare Sep 28, 2018

Keep up with Medicare news

February 2019 Anthem Kentucky Provider Newsletter Medicare Feb 1, 2019

Keep up with Medicare news

January 2019 Anthem Kentucky Provider Newsletter Medicare Jan 1, 2019

Keep up with Medicare news

December 2018 Anthem Kentucky Provider Newsletter Medicare Dec 1, 2018

Keep up with Medicare news

March 2019 Anthem Provider Newsletter - Kentucky Medicare Mar 1, 2019

Keep up with Medicare news - April 2019

April 2019 Anthem Provider Newsletter - Kentucky Medicare Apr 1, 2019

Keep up with Medicare news - January 2021

View these Medicare articles:
- Medicare Advantage Group Retiree Quick Reference Guide and FAQ
- Medicare Advantage Group Retiree Member Eligibility, Alpha Prefix FAQ
- SNF admission reporting requirements for D-SNP plans
- Policy Update: Nurse Practitioner and Physician Assistant Services – Professional
- Updates to AIM Clinical Appropriateness Guidelines for Radiation Oncology
January 2021 Anthem Provider News - Kentucky Medicare Jan 1, 2021

Keep up with Medicare news - May 2019

May 2019 Anthem Provider Newsletter - Kentucky Medicare May 1, 2019

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

Keep up with Medicare News -- July 2019

July 2019 Anthem Provider News - Kentucky Medicare Jul 1, 2019

Keep up with Medicare News -- June 2019

June 2019 Anthem Provider Newsletter - Kentucky Medicare Jun 1, 2019

Let’s Vaccinate

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

Maximizing efficient, high quality COVID-19 screenings

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

MCG Care Guidelines 25th Edition

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

Medical drug benefit clinical criteria updates

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

Medical drug benefit clinical criteria updates

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

Medical drug benefit clinical criteria updates

October 2020 Anthem Provider News - Kentucky Medicare Oct 1, 2020

Medical drug benefit clinical criteria updates

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

Medical drug benefit clinical criteria updates

September 2020 Anthem Provider News - Kentucky Medicare Sep 1, 2020

Medical drug benefit clinical criteria updates

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

Medical drug benefit Clinical Criteria updates - December 2019

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

Medical drug benefit clinical criteria updates - February 2021

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

Medical drug benefit Clinical Criteria updates - November 2019

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

Medical drug Clinical Criteria updates

December 2019 Anthem Provider News - Kentucky Medicare Dec 1, 2019

Medical drug Clinical Criteria updates

October 2019 Anthem Provider News - Kentucky Medicare Oct 1, 2019

Medical policies and clinical utilization management guidelines update

December 2020 Anthem Provider News - Kentucky Medicare Dec 1, 2020

Medical policies and clinical utilization management guidelines update

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

Medical policies and clinical utilization management guidelines update

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

Medicare Advantage Group Retiree Member Eligibility, Alpha Prefix FAQ

December 2020 Anthem Provider News - Kentucky Medicare Dec 1, 2020

Medicare Advantage Group Retiree PPO plans and National Access Plus FAQ

January 2020 Anthem Provider News - Kentucky Medicare Jan 1, 2020

Medicare Advantage member Explanation of Benefits redesigned

January 2019 Anthem Kentucky Provider Newsletter Medicare Jan 1, 2019

Medicare News - April 2020

View these Medicare notices:
- Coding tip for psychological and neuropsychological testing
- Medical Policies and Clinical Utilization Management Guidelines update
- New Medicare Advantage opioid treatment Program benefit
- Prior authorization requirements: new 2020 codes for coverage and precertification
April 2020 Anthem Provider News - Kentucky Medicare Apr 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

Medicare News - February 2020

February 2020 Anthem Provider News - Kentucky Medicare Feb 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

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

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

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

Medicare News - March 2020

March 2020 Anthem Provider News - Kentucky Medicare Mar 1, 2020

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

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

Medicare News - November 2020

View these Medicare articles:
- AIM rehabilitation prior authorizations suspended for Group Retiree Solutions members until December 31, 2020
- Transition to AIM Rehabilitative Service Clinical Appropriateness Guidelines
- AIM Musculoskeletal program expansion postponed
November 2020 Anthem Provider News - Kentucky Medicare Nov 1, 2020

Medicare News - October 2020

View these Medicare articles:
- Evaluation and management services correct coding
- Medical policies and clinical utilization management guidelines update
- Prior authorization requirements for the below codes effective January 2021
October 2020 Anthem Provider News - Kentucky Medicare Oct 1, 2020

Medicare News -- August 2019

August 2019 Anthem Provider News - Kentucky Medicare Aug 1, 2019

Medicare News -- December 2019

December 2019 Anthem Provider News - Kentucky Medicare Dec 1, 2019

Medicare News -- January 2020

January 2020 Anthem Provider News - Kentucky Medicare Jan 1, 2020

Medicare News -- November 2019

November 2019 Anthem Provider News - Kentucky Medicare Nov 1, 2019

Medicare News -- October 2019

October 2019 Anthem Provider News - Kentucky Medicare Oct 1, 2019

Medicare News -- September 2019

September 2019 Anthem Provider News - Kentucky Medicare Sep 1, 2019
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