Anthem BCBSMedium ImpactDocumentation
[California] Enhancing claims accuracy for inpatient sepsis and some newborn DRG submissions with full medical records
Published May 3, 2026
AI Summary
Anthem California is now requiring full medical records submission for inpatient sepsis and certain newborn DRG claims to improve claims accuracy. This change affects hospitals and practices that submit inpatient claims for these specific conditions.
Action Required
Immediately: Billing teams must submit complete medical records with all inpatient sepsis and specified newborn DRG claims to Anthem California. Update claim submission workflows to include full documentation package. Incomplete submissions may result in claim delays or denials.
Plan Types
All Plans
States
CA
Specialties
hospitalist, critical-care, emergency-medicine, pediatrics, infectious-disease