Reimbursement policy update - Claims Requiring Additional Documentation (facility)

In the May 2020 edition of Provider News, we announced an upcoming change to our Claims Requiring Additional Documentation policy (facility) for inpatient and outpatient facility claims effective August 1, 2020. Please be advised we are delaying the implementation date of the change for outpatient facility claims to October 1, 2020.

 

Effective for dates of service on or after October 1, 2020:

 

• 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 the Reimbursement Policies page at anthem.com.  

 

570-0820-PN-NH