Insurance Updates
Anthem
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...
Anthem Update: Electronic payments starting in mid-October 2025
Update 11.28.2025: Following the announcement in October’s Connection regarding Anthem’s transition of providers to EFT, we have heard from several chiropractors who have identified missing or delayed payments when receiving payments via virtual credit cards. To...
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
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
2026 Medicare Fee Schedule for Chiropractors
NOTE: We will be keeping a watchful eye on the Medicare fee schedule. There is a chance this will change at the end of the year or in early January. Please keep an eye out for any changes. If you are seeing a different fee schedule, please let us know. We do not...
2026 Medicare Information for Chiropractors
Medicare has announced the 2026 Part B cost updates, with the monthly premium increasing to $202.90 and the annual deductible rising to $283. These changes may affect patient cost sharing early in the year, particularly for covered chiropractic adjustments, since...
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...