MedicaidDocumentationHigh impact
[Virginia] Billing reminders for manually priced durable medical equipment
Anthem BCBS·VA·Claims & Billing
Effective date
Jul 26, 2026
We identified it
Jul 28, 2026
Summary
HealthKeepers, Inc. (Anthem Medicaid in Virginia) has issued mandatory billing requirements for manually priced durable medical equipment (DME). Providers must now submit itemized invoices (not purchase orders) attached at claim submission with descriptions matching the claim, and clearly document the count of individual items per billed unit (e.g., '1 box = 100 swabs'). Claims that do not meet these requirements will be delayed or deemed ineligible for reimbursement.
Action Required
Immediately effective July 26, 2026: (1) Billing team must update DME claim submission workflows to REQUIRE itemized invoices (manufacturer/distributor invoices only—reject purchase orders) attached at the time of claim submission. (2) Update billing software validation rules to flag claims where item descriptions do not match invoice descriptions or lack matching part numbers. (3) Create mandatory documentation template requiring staff to specify the count of individual items per billed unit container (box, case, kit, etc.) on all attached invoices before submission. (4) Verify invoice dates for perishable items as part of pre-submission quality checks. (5) Train all billing and claims staff on these requirements immediately. (6) Implement a pre-submission checklist in your billing system. Failure to comply will result in claim delays and denials from HealthKeepers, Inc. for all Virginia Medicaid DME claims.