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Update: Delayed Q4 2019 Claim Editing Changes to be Implemented

On or around January 31, 2020, we will implement the delayed fourth quarter (Q4) claim edit changes/updates addressed originally in the news item posted on November 1, 2019.

We encourage you to review details of this update in our Quarterly Claim Editing Update Report

  • The changes noted in this report will be implemented on or about January 31, 2020.

    The effective date of the changes noted in this report will be October 1, 2019 (unless otherwise specified in the report). Changes noted in this report apply to all claims finalized on and after our implementation date.¹

Read more about our Claim Editing Policies.

If you have questions, call a Physician Services representative at 1-800-624-1110 or an Institutional Services representative at 1-888-666-2535, Monday through Friday, between 8 a.m. and 5 p.m., Eastern Time.

¹Claims finalized before this update is implemented will not be adjusted following the implementation for the sole purpose of ensuring conformity with these claim editing rules. If a claim finalized before the implementation is adjusted after the implementation for other reasons, the claim editing rules noted here will be applied.

Published on: January 23, 2020, 01:11 a.m. ET
Last updated on: March 11, 2022, 03:59 a.m. ET