Claim edit enhancements for outpatient facility claims
Beginning in May 2019, we will enhance our claims editing systems to include outpatient facility editing.
These edits will:
- Help ensure correct coding and billing practices are being followed
- Help ensure compliance with industry standards such as American Medical Association (AMA), National Uniform Billing Committee (NUBC), and national specialty and academy guidelines
- Reinforce compliance with standard code edits and rules (i.e., CPT, HCPCS, ICD-10, NUBC)
February 2019 Anthem Maine Provider Newsletter