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Renew by Dec. 15 for Jan. 1 coverage. Stay covered with Ambetter Health.

Renew by Dec. 15 for Jan. 1 coverage. Stay covered with Ambetter Health.

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Newborn Inpatient Stays Provider Notice

Date: 07/28/25

Thank you for your continued partnership with Ambetter of Illinois (Ambetter Health).

We are committed to continuously evaluating and improving overall payment integrity solutions as required by state and federal governing entities. To that end, Ambetter Health will implement the Newborn Inpatient Stays policy, effective on or after November 1, 2025.

Thank you again for your cooperation and continued participation in our ongoing efforts to render quality healthcare to our members.

Find the Newborn Inpatient Stays policy on the Ambetter Health Clinical & Payments Policies.  

Policy Number

CC.PP.075

Policy Name

Newborn Inpatient Stays

 

Line of Business Impacted

Marketplace (Ambetter Health)

 

EX Code

Marketplace: EXhn (Retain Pay): Healthy Newborn Claim paid per policy, remit records for reconsideration 

Description

Review claims for coding appropriateness when normal newborn stays with non-NICU revenue codes are billed.