Updates to Use of a Non-Participating Provider Advance Patient Notice Policy
Effective April 1, 2021, several updates to the Advance Notice Policy will be implemented. If a member is scheduled to receive a service or procedure from a non-participating provider, the referring participating provider must provide advance notification to the member so the member may choose whether to oppose or approve the use of a non-participating provider for the service or procedure. The notice must be provided, completed, and dated by the member, and retained in the member’s medical file a minimum of seven (7) days in advance of the procedure or service. In addition, providers or facilities who are instructed to provide copies of signed advance notice policies as the result of an audit will now be required to respond with the required information within fifteen (15) days.
This policy will continue to apply to both facilities and professional providers. The updated policy in its entirety may be viewed on anthem.com/provider > Connecticut > Scroll down and select Find Forms > Use of a Non-Participating Provider Advance Patient Notice Policy.
March 2021 Anthem Connecticut Provider News