Outpatient prepay itemized bill review program

Effective for dates of service on or after November 1, 2022, Anthem will implement an Outpatient Prepay Itemized Bill Review Program which will require an itemized bill for local, host and ambulatory surgery center outpatient claims more than $100,000. We will review outpatient claims of more than $100,000 billed at a percent of charge prior to reimbursement to ensure items and services included on the claim are reimbursable.

 

CTBCBS-CM-003257-22