We want to assist physicians, facilities and other providers in accurate claims submissions and to provide the basis for reimbursement if the service is covered by a member’s benefit plan. Keep in mind that determination of coverage under a member's benefit plan does not necessarily ensure reimbursement. Please note:
- These policies may be superseded by state, federal or CMS requirements.
- Providers and facilities are required to use industry standard codes for claim submissions.
- Services should be billed with CPT® codes, HCPCS codes and/or revenue codes.
- The billed code(s) should be fully supported in the medical record and/or office notes.
- Industry practices are constantly changing, and we reserve the right to review and revise policies periodically.
Provider tools & resources
- Log in to Availity
- Launch Provider Learning Hub Now
- Learn about Availity
- Prior Authorization Lookup Tool
- Prior Authorization Requirements
- Claims Overview
- Reimbursement Policies
- Provider Manuals, Policies & Guidelines
- Provider Training Academy
- Pharmacy Information
- Provider News & Announcements