MedicaidReimbursementMedium impact
[Virginia] NOVA claims update: corrected rates and reprocessing timeline
Anthem BCBS·VA·Provider Bulletin
Effective date
Apr 1, 2026
We identified it
May 3, 2026
Summary
Anthem HealthKeepers Plus corrected a county mapping error in their claims system that caused waiver service claims for Northern Virginia (NOVA) members to be reimbursed at the Rest of State (ROS) rate instead of the higher NOVA rate. The system will be updated to use state FIPS county codes by April 1, 2026, and previously underpaid claims will be reprocessed within 60 days.
Action Required
By April 1, 2026: Billing team should verify that Anthem HealthKeepers Plus claims for NOVA-county members are processing at the correct NOVA reimbursement rate in the billing system. Monitor claim submissions after April 1 to confirm proper rate application. Between April 1 and May 31, 2026: Track and reconcile reprocessed claims for any NOVA member services that were previously underpaid to ensure credits are received. Document any discrepancies and contact Anthem Provider Services at 800-901-0020 if corrections are not received within the stated 60-day timeline.