Insurance Updates
Anthem
Humana and Anthem Chiropractic Issues Update
Humana Medicare Advantage We have begun to see Humana Medicare Advantage claims processing with payments issued toward the end of December. This is a positive development. We are continuing to actively monitor claims activity to ensure consistency and to identify any...
Claim filing update for contiguous county members
Starting December 18, 2025, claims that meet the criteria below must be submitted directly to Anthem. This update removes the need to verify the member’s home address, enhancing claims filing efficiency. If you do not have a contiguous contract, this change will not...
Humana
Humana and Anthem Chiropractic Issues Update
Humana Medicare Advantage We have begun to see Humana Medicare Advantage claims processing with payments issued toward the end of December. This is a positive development. We are continuing to actively monitor claims activity to ensure consistency and to identify any...
KAC Member Insurance Alert: Humana Medicare Advantage Claim Denials
The Kentucky Association of Chiropractors has been made aware of a developing issue involving Humana Medicare Advantage plans. It has come to our attention that certain Humana Medicare Advantage replacement plans are denying chiropractic claims based on...
WellCare
Ambetter Updates
Effective January 1, Ambetter has become an independent marketplace plan for Kentuckians. We have recently communicated with Ambetter regarding their chiropractic policies following the transition. It has come to our attention that the separation of their...
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
Medicare ABN Form Set to Expire January 31, 2026
The Advance Beneficiary Notice of Noncoverage (ABN), which must be provided to patients when Medicare may not cover a service, is currently scheduled to expire on January 31, 2026. Chiropractic physicians should be aware that the Centers for Medicare and Medicaid...
Humana and Anthem Chiropractic Issues Update
Humana Medicare Advantage We have begun to see Humana Medicare Advantage claims processing with payments issued toward the end of December. This is a positive development. We are continuing to actively monitor claims activity to ensure consistency and to identify any...
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...