As previously communicated in the December 2017 Network Update provider newsletter, Anthem Blue Cross and Blue Shield has established a contractual relationship with Alliant Health Solutions to assist us in validating provider compliance with applicable reimbursement guidelines and to identify instances of incorrect billing for behavioral health services.  Alliant – a behavioral health audit and review company – will examine Anthem’s outpatient behavioral health claims data.  Alliant has initiated the work, and your compliance is required should you receive a request for information. 


Utilizing systematic sampling methodology and a broad range of algorithms, the audits and findings will be customized to support Anthem’s expectations as outlined in the Anthem Provider Manuals and related guidelines and procedures.  Alliant’s findings may result in provider audits and record reviews, education and other direct outreach. 

Featured In:
August 2018 Anthem Provider Newsletter -- Virginia