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
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WellCare
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Passport
Modifiers
Passport is now requiring “Always therapy codes” to be billed with the GP modifier. This was presented in the ENews here http://passporthealthplan.com/wp-content/uploads/2019/07/Therapy-Modifiers.pdf . Providers will need to...
Preauthorization
The KAC Insurance Relations Committee has some exciting news for your practice. Passport Health Plan has announced in its most recent ENews that Effective August 1st, 2019 Passport will no longer require preauthorization for treatment in your office. Over the...
Humana Medicaid
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Aetna Better Health
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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
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