Insurance Updates
Anthem
Recoupment Request for No Prior Authorization
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...
Anthem Update – Modifier Rules and Guidelines for “Always Therapy” Codes
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...
Humana
Prior Authorization
Humana has reinstated the prior authorization requirement on the first date of service. This went into effect starting October 1, 2019. Please remember to obtain authorization at the start of care and not after the eighth...
Modifiers
Providers have been experiencing several issues regarding claims processing with Humana Commercial insurance plans. Most of these are due to modifiers not being attached. They have recently stated they follow Medicare guidelines and therefore you...
WellCare
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Passport
Passport 10-7
We continue to work on denials from Passport when billing both a spinal adjustment and an extremity adjustment. We have been told by Passport provider reps this edit has been identified and fixed. However, providers are still seeing these denials. All affected...
Molina Healthcare of KY
Governor Andy Beshear has announced effective January 1, 2021 two new MCOs will be assuming Medicaid claims processing in Kentucky. One of those companies is Molina of KY. It is always your decision to credential with any insurance company. The KAC just wanted to...
Humana Medicaid
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Aetna Better Health
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Medicare
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...
Updated 2023 Medicare Fee Schedule for Chiropractors
We originally posted all things related to 2023 Medicare Fee Schedule here. This article is a reflection of the updated Medicare Fee Schedule after congress passed the Omnibus bill late 2022. The current fees are reflected below. Most chiropractors are in a...
Miscellaneous
Update Your License
Your Chiropractic license renewal deadline was March 1st, 2020. If you have not already renewed your license you can do that through the new online application by clicking here, but your renewal will be subject to a $300 fine due to missing the March 1st...
HIPPA & Microsoft Windows
Microsoft has announced that they will be ending their extended support of Windows 7 operating systems on January 14th, 2020. After this date, Microsoft will no longer release updates and important security patches for Windows 7 operating systems. This means that the...