Reimbursement Policy Update - Claims requiring additional documentation (Facility)

As we advised you on April 1, 2018 in a separate Provider Communication, in our efforts to improve payment accuracy and reduce post-payment recoveries, beginning with dates of service on or after July 13, 2018, Anthem updated our Claims Requiring Additional Documentation policy to include the following requirement: 

• Inpatient stay claims reimbursed at a percent of charge with billed charges above $40,000 require an itemized bill to be submitted with the claim.

 

For more information, view this policy online.  Go to anthem.com, select Providers, then Providers Overview. Select Find Resources for Your State, and pick Colorado.  From the Answers@Anthem page, select the Reimbursement Policies – Facilities link, then Claims Requiring Additional Documentation.

 

In addition, visit our anthem.com provider website to view the instructions on how to submit your itemized bill to Anthem.