State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageJune 1, 2021

Inpatient readmissions policy reminder

As a reminder, AMH Health, LLC does not allow separate reimbursement for claims that have been identified as a readmission to the same hospital for the same, similar or related condition unless provider, federal or CMS contracts and/or requirements indicate otherwise, as further described in the existing reimbursement policy located on our website.

 

If AMH Health determines that this reimbursement policy has not been followed, AMH Health may deny the claim prior to payment or recover any paid claim. Providers may dispute any claim denied under this policy consistent with applicable law, your agreement with AMH Health and AMH Health policies.

 

For more detailed information on the Inpatient Readmissions reimbursement policy, please visit our reimbursement policies website.  

 

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