Reimbursement Policies

We want to help physicians, facilities and other health care professionals submit claims accurately. This page outlines the basis for reimbursement if the service is covered by an Anthem member’s benefit plan. Keep in mind that determination of coverage under a member's plan does not necessarily ensure reimbursement. Industry practices are constantly changing, and Anthem reserves the right to review and revise these policies periodically.

Definitions and Disclaimers

These policies serve as a guide to assist you in accurate claims submissions and to outline the basis for reimbursement if the service is covered by a member’s Anthem Blue Cross and Blue Shield benefit plan. The determination that a service, procedure, item, etc. is covered under a member's benefit plan is not a determination that you will be reimbursed.

Reimbursement Policy Disclaimers 

General Reimbursement Policy Definitions