Anthem software upgrade caused widespread claims payment errors in March

April 14, 2016
Area(s) of Interest: Commercial Payors Payor Issues and Reimbursement 

Anthem Blue Cross recently announced that a software upgrade the weekend of March 19 resulted in a zero allowance for some provider claims. According to Anthem, approximately 130,000 claims were affected. The error was resolved on Thursday, March 24.

The California Medical Association (CMA) was made aware of this problem by calls from members to our reimbursement help line. Anthem advised CMA that all impacted claims will automatically be reprocessed within 90-120 days and physicians do not need to resubmit claims or file appeals.  Interest and penalties will automatically be applied to those claims where required by state law. CMA was told that the insurer is reprocessing the claims on a priority basis.

Contact: CMA reimbursement help line, (888) 401-5911 or economicservices@cmadocs.org.


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