Clinical Laboratory Improvement Amendments

Please note, this communication applies to Anthem HealthKeepers Plus, Medallion and Anthem HealthKeepers Plus, Commonwealth Coordinated Care Plus (Anthem CCC Plus) offered by HealthKeepers, Inc.

 

Effective October 1, 2022, claims submitted with incorrect Clinical Laboratory Improvement Amendments (CLIA) information in accordance with the Centers for Medicare & Medicaid Services (CMS) policy will result in a claim rejection.

 

CMS considers a claim with missing or invalid CLIA information as an unclean claim, and the claim will be rejected by HealthKeepers, Inc. on the front end. Rejected claims will require claim resubmission to HealthKeepers, Inc. for the claim to be considered for reimbursement. Rejected claims do not have appeal rights nor are they counted toward any timely filing requirements.

 

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

 

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