Anthem Blue Cross : Anthem SmartValue Private Fee for Services (PFFS)
Anthem SmartValue Private Fee for Services (PFFS)
Plan & Administrative Changes/Updates for Providers:
We will continue to provide PFFS run- out services for 2011 dates of service through 12/31/12. For original claims, providers have one year from the date of service to submit a claim for processing. Provider submitted adjustment (determination) requests, for PFFS providers, will be accepted up to one year from the original claim processing date or the date of the most recent claim determination.
Click herefor important Medicare Advantage updates!
SmartValue from Anthem Blue Cross is a family of innovative Medicare Advantage Private Fee-for-Service plans available to Medicare beneficiaries in select areas and participation is easy:
FAST TRACK APPEAL PROCESS
Providers (SNFs, Rehab Facilities and Home health Agencies) are responsible for issuing Notice of Non-Coverage Detailed Explanation of Non-Coverage letters. For more information and to down load templates of these letters, click here. Do NOT use the CMS template for the Notice of Medicare Non-Coverage (NMNC) found on the CMS website. Instead please contact the entity who made the determination for a branded copy of the form.
Institutional billing codes are available from the NUBC via the NUBC's Official UB-04 Data Specifications Manual. To be redirected to NUBC click here