This article is for hospitals and facilities caring for our members
For inpatient admissions starting on or after January 1, 2025, if a commercial (HMO, PPO, Indemnity) member’s coverage ends during their inpatient care, we will cover their stay through the last date of coverage unless otherwise required by law. This change aligns with industry standards, will not impact admissions prior to January 1, 2025, and will not apply to Medicare Advantage or Federal Employee Program (FEP) members.
On January 1, we will update our Inpatient Acute Medical Admission payment policy to align with this member benefit change.
To download our payment policies, log in and click Find a Payment Policy on the right side of your home page. Or, go to Office Resources>Policies & Guidelines>Payment Policies.
Questions?
If you have any questions, please call Network Management and Credentialing Services at 1-800-316-BLUE (2583). As always, thank you for the care you provide to our members.
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