Reimbursement Policy Update: Claims requiring additional documentation (Facility)*
Outpatient facility claims reimbursed at a percent of charge with billed charges above $20,000 require an itemized bill to be submitted with the claim.
For more information about this policy, visit the Reimbursement Policies page on the anthem.com provider website for your state: Indiana, Kentucky, Missouri, Ohio, Wisconsin.
May 2020 Anthem Provider News - Wisconsin
Anthem Blue Cross and Blue Shield (Anthem) continues to take steps to improve the payment accuracy of provider claims and reduce post-payment recoveries. To this end, beginning with dates of service on or after August 1, 2020, Anthem will update its claims requiring additional documentation policy to include the following requirement: