Anthem periodically reviews claims submitted by providers to help ensure that benefits provided are for services that are included in our members’ benefit plans. Some providers are submitting claims for point-of-use convenience kits that are used in the administration of injectable medicines or other office procedures. These prepackaged kits contain not only the injectable medicine, but also non-drug components including, but not limited to, alcohol prep pads, cotton balls, band aids, disposable sterile medical gloves, povidone-iodine swabs, adhesive bandages and gauze.

 

Typically, the cost of a convenience kit exceeds the cost of its components when purchased individually. As a reminder, non-drug components included in the kits are inclusive of the practice expense for the procedure performed for which no additional compensation is available to the provider.

 

Please refer to Anthem’s Global Surgery and/or Bundled Services and Supplies Reimbursement Policies located at anthem.com for additional information.



Featured In:
December 2018 Anthem Indiana Provider Newsletter