Program date change for Anthem HealthKeepers Plus therapy requests

The date for the transition of medical necessity review of physical, occupational, and speech therapy (PT/OT/ST) services for Anthem HealthKeepers Plus members to the Carelon Rehabilitation Solution has changed to September 1, 2024. Despite the date change, for dates of service on or after August 1, 2024, no prior authorization is required for Anthem HealthKeepers Plus members for the first eight treatment visits for each new therapy episode of care, per therapy discipline as published in the June 2024 edition of Provider News.

How to submit a prior authorization request for the ninth and subsequent visits for an episode of care:

• Requests for dates of service up to and including August 31, 2024, will continue to be reviewed by HealthKeepers, Inc.
• Online: Use the Availity Essentials platform.
• Fax: 866-920-4096
• Requests for dates of service on or after September 1, 2024, will be reviewed by Carelon Medical Benefits Management, Inc.:
• Online: The ProviderPortal_SM is available 24/7, fully interactive, and processes requests in real-time using Clinical Criteria. To register, go to providerportal.com.
• The ProviderPortal_SM will be available for order request submission beginning August 26, 2024, for dates of service on or after September 1, 2024.
• Phone: Call toll-free at 855-574-6480, Monday through Friday between 8 a.m. and 5 p.m. ET.

Training webinars

Training webinars introducing the Carelon Rehabilitation Solution will be offered on the dates and times below. Please select the link under Meeting information to register.