New reimbursement policy: readmissions (Facility)

Effective January 1, 2019, Anthem does not allow separate reimbursement for claims that have been identified as a readmission to the same facility, or another facility that (i) operates under the same Facility Agreement, (ii) has the same tax identification number as Facility, or (iii) is under common ownership as Facility. This policy documents the Health Plan’s guidelines used to identify a readmission and the Health Plan’s guidelines for reimbursement related to a readmission.  For more information, review the policy dated January 1, 2019 by visiting the Reimbursement Policy page on our bcbsga.com/provider website.