CalChiro Scores WIN with CalPERS to Require Anthem to Re-adjudicate Claims
September 20, 2018
From the Managed Care & Insurance Committee
Representatives of the California Chiropractic Association (CalChiro) and CalPERS have met on two occasions to discuss Anthem’s claim adjudication process, specifically related to the application of claims that were processed under the deductible. In turn, CalPERS representatives met with Anthem, and Anthem has agreed to re-adjudicate those claims processed in error under the member’s deductible and issue additional payment for those claims. It is anticipated that this process should be concluded in the next 4-6 weeks. CalChiro and CalPERS will monitor this issue with Anthem. Please watch for these payments and notify CalChiro if your office staff notes any inaccurate claims payment, or other issues related specifically to CalPERS members/patients whose benefits are adjudicated by Anthem.