Blue Cross Blue Shield of Kentucky

Providers - Kentucky

Welcome, providers!

Resources that help healthcare professionals do what they do best — care for our members.

At Anthem Blue Cross and Blue Shield Medicaid (Anthem), we value you as a provider in our network. That's why we’ve redesigned the provider site to make it more useful for you and easier to use.

Interested in joining our provider network? We look forward to working with you to provide quality services to our members.

COVID-19 information

Anthem is closely monitoring COVID-19 developments and how the novel coronavirus will impact our customers and provider partners.

Receive email from Anthem Blue Cross and Blue Shield Medicaid (Anthem)

Anthem sends provider bulletins, policy change notifications, educational opportunities and other provider updates via email. Use the Provider Maintenance Form to update your email.

Availity access

The Availity Portal offers healthcare professionals free access to real-time information and instant responses in a consistent format regardless of the payer.

At Availity, you can:

Request authorizations.
Submit claims.
Confirm eligibility.

Learning opportunities

Find learning opportunities to assist with administering your patient’s health plan using Availity Essentials multi-payer features and payer spaces applications. Use the library of self-paced courses and instructor-led training sessions, available 24/7 at no cost. Be prepared with the knowledge to assist our members.

Provider news

The latest articles and announcements on our Medicaid policies, processes, updates to Clinical Guidelines, claims filings, state and federal regulatory changes, and more:

Medicaid updates

Register Today: Continuing to Explore the Intersection of Race and Disability

Register today for the Exploring the Intersection of Race and Disability forum hosted for providers on September 21, 2022. We believe that continuing the discussion we started at our June 2022 event to deepen the conversation about the disability experience for people of color is critically important.

Effective July 1, 2021, the following changes will be made to the Kentucky Medicaid pharmacy benefit:

  • All Kentucky Medicaid managed care organizations (MCO), including Anthem Blue Cross and Blue Shield Medicaid, will be partnering with MedImpact* for pharmacy claims processing and pharmacy prior authorizations (PA).
  • All PAs will be managed by MedImpact. Call 844-336-2676 or fax all retail pharmacy PA requests to 858-357-2612 beginning July 1, 2021. You may also submit your request online through Cover My Meds,* Surescripts,* or CenterX ePA* websites. For all medically billed drug (Jcode) PA requests, continue to send those directly to Anthem Blue Cross and Blue Shield Medicaid for review.

* MedImpact, Cover My Meds, Surescripts, and CenterX ePA are independent companies providing some pharmacy benefit services on behalf of Anthem Blue Cross and Blue Shield Medicaid.

Early and periodic screening, diagnosis and treatment FAQ

An EPSDT clinic or other organization qualified to provide a screening service, including a local health department, shall be under the direction of a licensed physician, pediatric advanced registered nurse practitioner, or registered professional nurse currently licensed by the state of Kentucky.

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

Effective for dates of service on and after September 11, 2022, the following updates will apply to the AIM Specialty Health®* (AIM) Advanced Imaging Clinical Appropriateness Guidelines. As part of the AIM guideline annual review process, these updates are focused on advancing efforts to drive clinically appropriate, safe, and affordable healthcare services.

Register today: Exploring the intersection of race and disability

Anthem is committed to making healthcare simpler and reducing health disparities. Open discussion about the disability experience for people of color and reducing implicit bias for those in healthcare is critical to improving the health and well-being of the communities in which we live and serve — all Americans.

Featured resources

Pharmacy information

Search for up-to-date drug information, including hundreds of brand-name and generic medications.

Maternal child program

When it comes to our pregnant members, we are committed to keeping both mom and baby healthy. That’s why we encourage all our moms-to-be to take part in our New Baby, New LifeSM program, a comprehensive, proactive case management and care coordination program for all expectant mothers and their newborns.

Behavioral health providers

We work collaboratively with hospitals, group practices and independent behavioral health care providers, community and government agencies, human service districts and other resources. This enables Anthem to meet the needs of members with mental health and substance use disorders as well as those with intellectual and developmental disabilities.

Need to report changes in practice status to Anthem?

Please complete the Provider Maintenance Form.

Government resources

Kentucky Cabinet for Health and Human Services: Department for Medicaid Services

Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield Medicaid.

Provider tools & resources

Interested in becoming a provider in the Anthem network?

We look forward to working with you to provide quality services to our members.