Getting paid: Anthem's new prepay review policy targets unbundling modifiers

Why This Topic Matters

Payer prepayment review policies can affect claim processing, payment timing, and documentation expectations for practices that use common billing modifiers. Understanding the scope of the policy helps coding and billing teams prepare for review activity and monitor payer-specific requirements.

Article Sections

1. Overview of Anthem's prepayment review policy

   Introduces the payer policy change and the general claim types it affects across participating plans.

2. Policy details and review process

   Summarizes the timing of implementation, the parties involved in claim review, and the broader edit-screening context described by the payer.

3. Implications for practices and documentation

   Discusses the operational impact for billing workflows and the importance of supporting claim documentation.

4. Resources

   Lists plan-specific rollout dates and linked payer notices for affected regions and products.