Claims requiring additional documentation facility reimbursement policy update
- Inpatient stay claims reimbursed at a percent of charge with billed charges above $40,000 require an itemized bill to be submitted with the claim.
We continue to receive claims without the required itemized bill causing the claims to be returned for the itemization. To help ensure accuracy and eliminate delays in the adjudication of your claims, the itemized bill must be included with qualifying claim submissions.
For more information about this policy, visit the facility reimbursement page on our anthem.com provider website for your state: Indiana, Kentucky, Missouri, Ohio, Wisconsin.
In addition, visit our anthem.com provider website to view the instructions on how to submit your itemized bill to Anthem Blue Cross and Blue Shield.
September 2019 Anthem Provider News - Wisconsin