Claim payment disputes: Update

Please note, this communication applies to Anthem HealthKeepers Plus offered by HealthKeepers, Inc.

 

In September 2019, HealthKeepers, Inc. sent all providers the attached provider bulletin, outlining and confirming our claims payment dispute processes. Since then, the Anthem HealthKeepers Plus Provider Relations team has continued to allow providers to submit claims payment issues directly to them after completing the first level of the claims payment dispute process (reconsideration). Effective October 1, 2020, the Anthem HealthKeepers Plus Provider Relations team will no longer accept claims payment issues directly from providers who have not completed the second level of the claims payment dispute process (appeal).

 

In the meantime, the Anthem HealthKeepers Plus Provider Relations team will work with providers to transition them to this process and educate and train any providers on the process and supporting tools. All claims issues that have already been accepted by the Provider Relations team will be worked using the existing processes, and the Provider Relations team will notify providers of the outcomes.

Please refer to the bulletin in its entirety by selecting the document to the right under "Article Attachments." 

AVA-NU-0285-20