January 16, 2026

Aetna Better Health of Kentucky

Mandatory ADA Information of Requirement

To ensure federal (C.A.A 2023; P.L. 117-328 pt. 5123) and state compliance with accessibility standards and improve member experience, all new and existing provider data updates must include ADA (Americans with Disabilities Act) information, as indicated on rosters, applications, etc. Effective Feb. 4, 2026, any of the above document types submitted without the following ADA info will be returned, causing processing delays:

Contact your Network Manager with any questions or comments. Find contact information here.

Enhancement to the EviCore Prior Authorization Portal Update

Effective Mar. 1, 2026, EviCore, Aetna Better Health of KY’s vendor servicing prior authorizations for radiology, cardiology and pain management, is moving from their current Isaac platform to their new Image ONE platform. Under the enhanced process, requests will be submitted electronically via the CareCore National portal at www.EviCore.com (preferred method), telephonically by contacting the EviCore prior authorization unit (866-668-8295) or via fax (800-540-2406).

Please note: This is only a change in the portal used to process the prior authorization request. The clinical review process will not change. EviCore invites providers to register in advance to attend an online orientation. Each online orientation session is free of charge and will last approximately one hour. Additional training dates are to be determined. All sessions are scheduled in Eastern Standard Time (EST).

Upcoming ABH Provider Orientation for EviCore Portal Migration

Here’s how to register for an orientation session: 

For those unable to attend an orientation session, a copy of the presentation, as well as other important documents can be found online at https://www.evicore.com/resources/healthplan/aetna-better-health/kentucky.

Optum Behavioral Health: Arm yourself with substance and opioid abuse disorder resources

It’s a new year, but a familiar story. Drug overdose continues to be a leading cause of accidental death in the U.S.1 In addition, substance use among adolescents and young adults also increases the risk for both medical problems and multiple psychiatric disorders in adulthood and the following issues in adolescents:1

To help manage care efficiently, Optum has compiled resources to help screen and treat patients with Substance and/or Opioid Use Disorders:

Passport by Molina Healthcare

Passport by Molina Healthcare (Passport) encourages all providers and applicable office staff to review the Passport Payment Policy titled “High-Level E/M with Preventive Medicine,” effective Nov. 5, 2023. This policy outlines the appropriate reimbursement guidelines when submitting claims that include both high-level Evaluation and Management (E/M) codes and preventive medicine codes for the same patient, provider, and date of service. Ensuring compliance with this policy supports accurate claim processing and reimbursement.

Reimbursement:  Affected Codes: 99204, 99205, 99214, 99215 with 99385, 99386, 99387, 99395, 99396, 99397

When both preventive and high-level E/M codes are submitted, only the preventive code is reimbursed, irrespective of modifier use.

 Join Us for Monthly GLMS Practice Management Discussions

We’re excited to invite you to our Monthly Practice Management Discussions, a recurring opportunity to connect with peers, share insights and discuss important topics affecting your practice. Each session focuses on key health care updates, common challenges and solutions to improve practice management. We look forward to your participation in this valuable discussion! Next meeting: January 20, 2026, 8 a.m. – 9 a.m. Contact stephanie.woods@glms.org if you are interested in attending or have any questions.