Billing & payment news

2025 commercial fee schedules are available online

2025 commercial fee schedules are available online

June 29, 2025

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Understanding disallow code OX6

It’s important to us that you understand the way your claims are handled – including what the various codes that may appear on your remittance advice mean. One claim adjustment code we get a lot of questions about is OX6.

June 29, 2025

New and updated billing policies are now available

We’ve posted several new and updated billing policies, which align to industry standards, to the Provider Manual.

June 29, 2025

Resolving some vaccine codes denying incorrectly

We're correcting two issues with vaccine claims denying when they shouldn't.

June 29, 2025

Provider-based billing policy went into effect June 1

Our provider-based billing policy went into effect June 1.

June 29, 2025

Understanding why a claim denied

We've created a new resource to help you understand exactly why a claim may have denied and be able to take any appropriate next steps.

June 29, 2025

New or corrected claims requirement for retro authorizations

Starting Dec. 9, submit new or corrected claims when you get a retroactive authorization after a claim denial.

June 29, 2025

Submitting requested medical records for claims processing

Follow this process when submitting requested medical records to ensure they're linked with the right claim.

June 29, 2025

Void claims now appear on remittance advice with original claims

Since June 2024, void claims now appear on your remittance advice with the original claim adjustment.

June 29, 2025

Resolving claims denying incorrectly for no anatomical modifier

We're reprocessing claims that recently denied for no anatomical modifier when they shouldn't have.

June 29, 2025

Changes for Medicaid claims for select home health care services

Changes coming for Medicaid claims submissions for select home health care services

June 29, 2025

ER imaging claims reprocessing

We're adjusting ER imaging claims that rejected incorrectly for no authorization.

June 29, 2025