Policy UpdatesCommercialMay 1, 2020

Reimbursement policy update: Claims requiring additional documentation (Facility)

Anthem 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 August 1, 2020, Anthem will update its claims requiring additional documentation policy to include the following requirement: 
  • Outpatient facility claims reimbursed at a percent of charge with billed charges above $20,000 require an itemized bill to be submitted with the claim.


For more information about this policy, visit our Reimbursement Policy page at anthem.com/provider.

 

433-0520-PN-GA