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Renueve antes del 15 de diciembre para tener cobertura el 1 de enero. Mantén tu cobertura con Ambetter Health.

Renueve antes del 15 de diciembre para tener cobertura el 1 de enero. Mantén tu cobertura con Ambetter Health.

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Internal DRG Validation Notification

Fecha: 19/08/25

Dear Provider,

Thank you for your continued partnership with Ambetter from Meridian. As you know, 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 an additional review process that will take place beginning on or after 10/01/25.

Description

 

Lines of Business

Inpatient claims will be reviewed internally for DRG validation prior to utilizing external vendors. Medical records will be requested for selected claims and should be sent according to the instructions on the request correspondence.

Ambetter and Meridian Complete

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 Meridian