Insurance Updates
Anthem
January 25, 2022 – Insurance Update for Chiropractors
The KAC leadership continues to work hard on your behalf. Many of these updates were given in-person at our 2022 LB Payne Insurance Update. We wanted to send a follow up email reminding KAC members of these changes.Remember, if you are experiencing any issues, please...
Resources for Anthem
Here are a few resources for Anthem including the Alpha-prefix list for out of state plans and the Anthem provider rep map. We will update the provider rep map as it is sent to us. Resources Alpha prefix list for Ohio - click here Alpha prefix list for Indiana - click...
Humana
January 25, 2022 – Insurance Update for Chiropractors
The KAC leadership continues to work hard on your behalf. Many of these updates were given in-person at our 2022 LB Payne Insurance Update. We wanted to send a follow up email reminding KAC members of these changes.Remember, if you are experiencing any issues, please...
96/97 Modifier
The KAC is working on issues providers are having with Humana Commercial plans. One area we have had consistent complaints with is the 96/97 modifiers. Humana has informed us that these modifiers are only necessary when it is...
WellCare
No Changes To PreAuthorization
WellCare sent out communication on 2/28/2019 stating there “would be an increase focus on ensuring that our providers follow our existing pre-service authorization and notification requirements.” This does not change what services you will need to...
Passport
January 25, 2022 – Insurance Update for Chiropractors
The KAC leadership continues to work hard on your behalf. Many of these updates were given in-person at our 2022 LB Payne Insurance Update. We wanted to send a follow up email reminding KAC members of these changes.Remember, if you are experiencing any issues, please...
Updates to Coordination of Benefits (COB) for all KY Medicaid Managed Care Members
The KAC received the following update from Passport: DATE: July 1, 2021 TO: KY Medicaid Managed Care Organizations FROM: MedImpact Healthcare Systems Updates to Coordination of Benefits (COB) for all KY Medicaid Managed Care Members On Thursday, July 1, 2021, a...
Humana Medicaid
GP Modifier
Providers have reached out to the KAC regarding denials for therapy codes (97XXX) when billing Humana Caresource. It appears they are now requesting these codes be billed with the GP modifier. You can rebill any denied claims as corrected and attach the GP modifier...
Aetna Better Health
Children Under 3
We continue working with Aetna on a variety of issues including Medicare crossover claims and denials for care given to children under three. We have sent requested information to Aetna on both these issues and will update members as soon as we have more...
Children Under 3
The Insurance Relations Committee recently met with ABH representatives regarding several issues our members have brought to the KAC. At this time, ABH continues to deny claims for children under three years of age. We discussed the...
Medicare
Act now on the Chiropractic Medicare Coverage Modernization Act (H.R. 1610 / S. 799)
The Chiropractic Medicare Coverage Modernization Act (H.R. 1610 / S. 799) will allow Medicare beneficiaries access to the chiropractic profession’s broad-based, non-drug approach to pain management, which includes manual manipulation of the spine and...
New ABN released
The ABN, Form CMS-R-131, and form instructions are expiring as of June 30, 2023. The NEW ABN form has been issued by CMS. The use of the renewed form with the expiration date of 01/31/2026 will be mandatory on 6/30/23. You may...
Miscellaneous
New Medicaid MCO Contracts Awarded
On May 29th, Governor Beshear announced the new Medicaid MCO contracts that will take effect on January 1st, 2021. There will continue to be five MCO's with Aetna Better Health, Humana, and Wellcare having their contracts renewed. Molina Healthcare and...
Medicaid License Update
You will need to send your updated license to Medicaid prior to May 1, 2020. Medicaid now has a provider portal you will use to update your license. Some providers have reported this is not an easy process. The address for the Portal is located at the Partner...