The Provider Manual will be updated for an effective date of April 4, 2022, and will be available February 4, 2022, on the provider portal of our website at anthem.com.

 

The edits to the manual include the following clarifications:

  • Claim payment disputes can be submitted to dispute prepayment Itemized Bill Review findings.
  • Disputes of Itemized Bill Review findings do not fall under Clinical Appeals.
  • If a Provider or Facility does not agree with the Claim determination for Claims denied on a pre-payment review basis, Providers and Facilities should follow the instructions in the Claims Payment Disputes section of the manual.

 

Select Providers and then under Provider Resources, select Policies, Guidelines and Manuals. Enter Maine as state, scroll to Provider Manual and select Download the Manual.

 

Archived copies of the Provider Manual will remain available at the same location for reference of prior information. However, for current reference needs, please ensure that you select the July 2021 manual.

802-0222-EM-ME



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Maine Provider Manual update effective April 4, 2022