Providers who disagree with the outcome of a claim can dispute that outcome when the claim is finalized. The payment dispute process consists of two internal steps. Providers will not be penalized for filing a claim payment dispute.
Both steps can be done via Availity, fax or mail. Reconsiderations can also be submitted verbally through Provider Services.
For more information regarding the claim payment dispute process, please refer to Chapter 13 in the Provider Manual.
Visit the Indiana Health Coverage Programs fee schedule for reimbursement information for standard CPT, HCPCS and current dental terminology codes. Reimbursement for rendered services is based on negotiated rates.
HIP pays at Medicare rates or 130% of Indiana Medicaid rates if no Medicare rate exists. Visit the CMS fee schedule for Medicare reimbursement information. If no Medicare rate exists, visit the Indiana Health Coverage Programs fee schedule for Medicaid reimbursement information. Exception: Facility charges for individuals that qualify as low-income parents and caretakers, and 19- and 20-year-old low-income dependents enrolled in HIP will be reimbursed at Medicaid rates.
Anthem Blue Cross and Blue Shield
Mail Stop: IN999
P.O. Box 61010
Virginia Beach. VA 23466
Page Last Updated: 03/09/2021