Anthem Blue Cross and Blue Shield (Anthem) periodically reviews claims submitted by providers to help ensure that benefits provided are for services that are included in our members’ benefit plans. Some providers are submitting claims for point-of-use convenience kits that are used in the administration of injectable medicines or other office procedures. These prepackaged kits contain not only the injectable medicine, but also non-drug components including, but not limited to, alcohol prep pads, cotton balls, band aids, disposable sterile medical gloves, povidone-iodine swabs, adhesive bandages and gauze.

 

Typically, the cost of a convenience kit exceeds the cost of its components when purchased individually. As a reminder, non-drug components included in the kits are inclusive of the practice expense for the procedure performed for which no additional compensation is available to the provider.

 

Please refer to Anthem’s Global Surgery and/or Bundled Services and Supplies Reimbursement Policies for additional information.

 

Reimbursement Policies are available online

 

Go to anthem.com, select Providers, then Providers Overview.  Select Find Resources for Your State, and pick Colorado. From the Answers@Anthem tab, select the Reimbursement Policies - Facility or Reimbursement Policies - Professional link. Then search for the Policy you would like to view.



Featured In:
December 2018 Anthem Provider Newsletter - CO