Category:  Medicaid


Per the Department of Medical Assistance Services (DMAS), effective November 1, 2019, HealthKeepers, Inc. will require all Anthem HealthKeepers Plus providers to include their respective billing taxonomy codes on paper and electronic claims. This is in addition to their billing National Provider Identifier (NPI). Ensuring the taxonomy codes are included will prevent adverse impacts on Anthem HealthKeepers Plus claims submissions to the Commonwealth of Virginia. 

 

Additionally, for any claims submitted to Medicare for dual members, providers are required to include billing taxonomy codes. HealthKeepers, Inc. has confirmed that even though Medicare does not require the billing taxonomy codes, Medicare will accept and transfer them to HealthKeepers, Inc. when the claims cross over.

 

For claims submitted:

 

  • For electronic claims submissions, consult the Commonwealth of Virginia’s encounter processing solution (EPS) claims submission rules, which dictate that the billing provider NPI is included in loop 2010AA, segment NM109, and taxonomy is included in loop 2000A, segment PRV03.

 

  • For paper claims submissions, on a CMS-1500 form, include the taxonomy codes in box 33b.

 

  • For paper claims submissions, on a UB-04 form, include the taxonomy code in box 57 or in box 81.

 

If you have any questions about this communication, call Provider Services at 1‑800‑901‑0020 or Anthem CCC Plus Provider Services at 1‑855‑323‑4687



Featured In:
February 2020 Anthem Provider News - Virginia