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REIMBURSEMENT POLICY MEDICAL DEPARTMENT - Anthem These reimbursement policies serve as a guide to assist you in accurate claims submissions and to outline the basis for reimbursement if the service is covered by an Anthem Blue Cross and Blue Shield (Anthem) member’s benefit plan
Reimbursement Policy - Providence Health Plan When a member received observation services within three days prior to an inpatient admission to the same facility for a related condition, the Plan’s reimbursement method is to pay the entire stay as an inpatient admission
I. ABOUT OUR REIMBURSEMENT POLICIES - Johns Hopkins Medicine Johns Hopkins Health Plan LLC (JHHP) reimbursement policies serve as a guide to assist in accurate claim submissions and outline the basis for reimbursement of services covered by a member’s JHHP benefit plan
Evaluation and Management (E M) Policy, Professional This reimbursement policy explains when medical records may be requested to ensure that the appropriate level of CPT E M code is reimbursed based on the health care services provided
Reimbursement Policy: Telehealth and Virtual Care Services Current billing and claims payment policies apply to all our products, unless otherwise noted We will inform you of new policies or changes in policies through postings to the Reimbursement Policies webpage on emblemhealth com
REIMBURSEMENT POLICY MEDICAL DEPARTMENT These reimbursement policies may be superseded by mandates in provider, state, federal, or Centers for Medicare Medicaid Services (CMS) contracts and or requirements We strive to minimize delays in policy implementation If there is a delay, we reserve the right to recoup and or recover claims payment to the effective date, in accordance with the policy We reserve the right to review and
REIMBURSEMENT POLICIES This general reference is one resource to provide guidance on MotivHealth’s reimbursement policies This document is not intended to address every aspect of how we will reimburse a claim