Billing Beat

Anthem to conduct post-service reviews of modifier 91

November 27, 2017

Beginning in the fourth quarter of 2017, Anthem Blue Cross and Blue Shield in Virginia will conduct post-service reviews of professional claims billed with following modifiers: 25, 62, 80, 81, 82, AS, and 91. Additionally, As part of the review, Anthem may contact providers with outlying billing practices to request additional documentation related to the services. If billing discrepancies are identified, Anthem will provide a written report of their findings to providers and initiate recoupments as appropriate. Findings may assist your office with quality improvement efforts.

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