decisionhealth Newsletters, Part B News - 2019 Issue 9 (September)
Anthem’s new prepay review policy will target Correct Coding Initiative bundles
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Article Overview
This article covers Anthem BlueCross BlueShield’s rollout of a prepayment clinical validation review process affecting claims associated with Correct Coding Initiative modifier use. It is relevant to physician practices, billing teams, and compliance staff that need to understand payer review activity, documentation readiness, and the general coding resources and payer policies referenced in the announcement.
Why This Topic Matters
The policy could affect claim processing, documentation requests, and revenue flow for practices in Anthem’s payer mix, so readers need to know what types of claims may be reviewed and what broad resources are cited in connection with the issue.
What You Will Learn
- What Anthem’s new prepayment review initiative is about
- Why practices should review their documentation and modifier use
- Which broad coding resources and payer policies are referenced
- Why physician organizations are paying attention to the policy change
Who Should Read This
- Physician practices
- Medical billing staff
- Coding professionals
- Compliance teams
- Physician specialty and state medical associations
Codes Discussed
Modifiers Discussed
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