CommercialJuly 1, 2025
Readmission review process change
Effective August 1, 2025, certain facilities will implement a new readmission review process that moves the review to the time of readmission request. This allows for an immediate review and notification to the facility of an admission that meets the contractual language of a readmission. It also provides the opportunity to communicate with Anthem’s medical director in the event of a contractual issue.
This change is an update in our processing and functions solely as a contractual review. This new process is not a change to any existing policy or contract. This new process is not a medical necessity review. The medical necessity review process remains unchanged.
Anthem Blue Cross and Blue Shield is the trade name of Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.
COBCBS-CM-085407-25
PUBLICATIONS: July 2025 Provider Newsletter
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