The KAC is currently seeking input from Kentucky Caresource providers. It has come to our attention claims have not been processing correctly. Our Insurance Relations team is working directly with Caresource to see if this is a state-wide issue and how this may be...
UPDATE These codes have been updated 12.28.2021 to mirror the delayed Medicare cuts passed by congress. The 2022 Medicare fee schedule has been released on the CGS website. For your convenience, the fee schedule is below. Should you wish to lookup the fee schedule on...
The KAC is aware that providers have been receiving recoupment requests for lack of prior authorization. In late 2019/early 2020, the KAC was successful in stopping Anthem from requiring prior authorization for chiropractors through AIM in Kentucky. Providers should...
Recently, Anthem announced they were changing their modifier rules for physical medicine and rehabilitation codes. This change took effect November 1, 2021. These codes and modifiers align with the codes the Centers for Medicare & Medicaid Services (CMS) has...
What exactly do you need to get prior authorization for Humana and UHC? UHC will need a prior authorization for any services that are deemed as “physical therapy.” These are typically the 97XXX codes. You can look up the code by following this...