By Carol Hoppe, CPC, CCS-P, CPC-I
The ISMA was recently informed that practices are being underpaid by Anthem on Evaluation and Management codes, and perhaps other codes as well. Anthem is aware of the issue, which Jacquie Marsalis, Anthem director, provider relationship account management said, “... is due to a fee schedule load issue that is currently being updated. Once we update our system, we will certainly start reprocessing any claims impacted."
Marsalis could not tell ISMA how many codes were affected or how long it may take to correct the issue, but did state, "We have educated our customer service team to assist with the calls. Our assigned PR reps are available to assist anyone with questions or concerns.”
Here is the most updated list of provider relations representatives. Please reach out to your assigned representative if you have any questions or if you have not received corrected payments in the next 30 days.