Avalon Healthcare Solutions: Laboratory Medical Policy Pay and Educate Alerts

In an effort to improve adherence to medical policies for laboratory services filed for places of service (POS): Hospitals (POS 22 and 19), Physician Offices (POS 11) and Independent Laboratories (POS 81), you may receive an alert message on upcoming remittances. This pay and educate alert indicates that a specific test did not meet BCBSSC medical policy criteria as well as the medical policy they used to make the determination. As of now, your claim payment will not be impacted, however, in the future, services may deny if the medical policies are not followed.