Claims Requiring Additional Documentation reimbursement policy update (Facility)

BCBSGa continues to take steps to improve the payment accuracy of provider claims and reduce post-payment recoveries. To this end, beginning with dates of service on or after January 1, 2019, BCBSGa will update its 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.

 

BCBSGa has engaged Ceris to administer the review of these claims.

 

For more information about this new policy, visit the Reimbursement Policy page on our bcbsga.com/provider website.