VMGMA and MSV announce changes in Anthem COB policy

1 July 2009

Several months ago, we were pleased to report that through a collaborative effort with Del. Dave Nutter of Christiansburg, VMGMA, the Medical Society of Virginia (MSV), and the Virginia Association of Health Plans, we were able to secure a compromise from Anthem on the issue of Coordination of Benefits (COB). At that time, we outlined a temporary "fix" utilizing a form to help avoid the delay in payment of claims due to the denial code stating the need for "more information from member."

Today, we are even more pleased to announce that Anthem is no longer going to use this denial code for State of Virginia employees for services rendered on or after July 1, 2009. Also, as other groups are added or renewed, the COB "search" cards will be a thing of the past. Eventually, Anthem will move towards a "pay and pursue" method involving COB which is similar to what we find with almost all of the insurers in Virginia.

Anthem has stated that by January 1, 2010, ALL of their member groups will be on this "pay and pursue" method, with the exception of a few self-funded groups that will still require some COB activity. Although it's your prerogative to continue to use the COB forms that we referenced in our previous correspondence, we suggest that for any dates of service on or after July 1, 2009, you should no longer need these forms for State of Virginia/CovaCare employees.

Thank you for all of your support and help over the past few months in both getting us to that interim step and also in now helping us to attain what was always our ultimate goal in eliminating this bothersome issue.

If you have any questions on this item, please feel free to e-mail your VMGMA representatives Eddie Clark at clarke@vaeye.com, or Bert Wilson at bwilson@dermva.com, or MSV's physician practice advocates Rose Moore at rmoore@msv.org or Lesley Wagner at lwagner@msv.org.