Anthem BCBSMedium ImpactDocumentation
[California] Enhancing claims accuracy: new process for inpatient sepsis and some newborn DRG submissions with full medical records
Published May 28, 2026
AI Summary
Anthem California is implementing a new claims accuracy process requiring full medical records submission for inpatient sepsis cases and specific newborn DRG submissions. This will likely require additional documentation gathering and submission processes for affected inpatient claims.
Action Required
Immediately: Billing team must establish process to submit complete medical records with all inpatient sepsis claims and specified newborn DRG submissions to Anthem California. Coordinate with medical records department to ensure timely documentation compilation. Monitor for specific DRG codes and effective date details from full policy document.
Plan Types
Commercial
States
CA
Specialties
hospitalist, critical-care, emergency-medicine, pediatrics, infectious-disease