Anthem to mail professional provider contract amendment in late May 2019

In late May, Anthem Blue Cross and Blue Shield and our affiliate HealthKeepers, Inc. will begin mailing network-participating professional providers information regarding changes to our existing provider agreements.  Along with changes to the provider agreements, we are updating our fee schedules, reimbursement policies and provider manual.  These changes will be effective September 1, 2019.  Professional providers who currently contract with Anthem and/or HealthKeepers, Inc. should receive an amendment to their existing provider agreements.  The amendments will be mailed on a computer disc (CD).

 

To continue network participation, no action will be required.  Providers who expect to receive an amendment package and do not do so by June 3, 2019, should contact their Anthem network manager to obtain a copy.

 

DME fee schedule adjustment

 

Effective with the amendment dated September 1, 2019, reimbursement for Durable Medical Equipment and Supplies (DME) will be adjusted for our Commercial and Medicaid lines of business.  DME fees are not among the 80% to 95% of Anthem’s aggregate health care spend. As such, DME reimbursement is not currently included in professional provider agreements for providers who are not specifically DME providers.  Given that many of our providers bill for DME services, we are providing notice of the adjustment in reimbursement.  If you would like a list of the impacted HCPCS codes and associated reimbursement effective September 1, 2019, for the DME codes you bill most often, please contact your Anthem network manager after May 24.