tci Medicare Compliance & Reimbursement - 2018 Issue 1
Industry Notes: New Anthem Imaging Policy Could Affect Your Paycheck
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Article Overview
This article reviews an Anthem Blue Cross Blue Shield imaging policy change and its potential reimbursement impact on hospital-owned outpatient facilities, emergency department settings, and referral patterns to independent imaging centers. It is intended for coders, billers, revenue cycle staff, and emergency medicine stakeholders who need to understand payer coverage trends and operational implications. The discussion focuses on the broad policy change, the affected care settings, and the timing of Anthem’s rollout across coverage areas.
Why This Topic Matters
Payer policy updates like this can change how imaging services are paid, alter where patients are directed for testing, and affect both facility revenue and patient financial responsibility.
What You Will Learn
- What type of payer policy change Anthem announced
- Which care settings may be affected by the imaging update
- Why the policy may matter for emergency departments and hospital-owned outpatient facilities
- When the policy was expected to be broadly implemented
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle staff
- Emergency department administrators
- Emergency physicians
- Facility compliance staff
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