News
Newborn Inpatient Stays Policy
Date: 04/25/25
Dear Provider,
Thank you for your continued partnership with Ambetter from WellCare of New Jersey. We are committed to continuously evaluating and improving overall Payment Integrity solutions as required by State and Federal governing entities. We are writing today to inform you of a new policy Ambetter from WellCare of New Jersey will be implementing effective on or after 1/1/2025.
Policy Number | CC.PP.075 |
Policy Name | Newborn Inpatient Stays |
Line of Business Impacted | Marketplace |
EX Code | 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. |
Thank you for your continued participation and cooperation in our ongoing efforts to render quality health care to our members. We look forward to helping you provide the highest quality of care for our members.
Sincerely,
Ambetter from WellCare of New Jersey