News
Enforcement of National Coverage Determination (NCD) Guidelines Policy
Date: 02/07/24
We are informing our provider partners of a new policy Ambetter will implement effective on or after February 15, 2024.
Thank you for your continued partnership with Ambetter as we continuously evaluate and improve the overall payment integrity solutions to render quality healthcare to our members, as required by state and federal governing entities. We look forward to helping you provide the highest quality of care.
| Edit Name | Description | Lines of Business |
|---|---|---|
| NCD Non-Covered Lab Diagnosis | Enforcement of National Coverage Determination (NCD) guidelines when diagnostic lab testing services are billed only with a diagnosis that is not covered per the NCD. | MMP Medicare Marketplace |