tci Medicare Compliance & Reimbursement - 2018 Issue 1

Industry Notes: New Anthem Imaging Policy Could Affect Your Paycheck

If you see patients who are covered by Anthem Blue Cross Blue Shield, it's a good time to brush up on that payer's latest imaging policy, which could negatively impact your pay. This past summer, Anthem began implementing a new policy that aims to stop paying for MRIs and CT scans performed in hospital-owned outpatient facilities. Instead, Anthem directs these patients to go to independent imaging centers for such scans and tests. The payer expects to have this policy in place across all of its coverage areas by March 2018. Anthem points to a three-pronged reason for these changes:...

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