Reimbursement policies

Wellpoint wants to help physicians, facilities, and other healthcare professionals submit claims accurately. This page outlines the basis for reimbursement if the service is covered by our member’s benefit plan. Keep in mind that determination of coverage under a member's plan does not necessarily ensure reimbursement. Industry practices are constantly changing, and Wellpoint reserves the right to review and revise these policies periodically.

Definitions and disclaimers

These policies serve as a guide to assist you in accurate claims submissions and to outline the basis for reimbursement if the service is covered by a member’s benefit plan. The determination that a service, procedure, item, and the like, is covered under a member's benefit plan is not a determination that you will be reimbursed.

Reimbursement policy disclaimers 

General reimbursement policy definitions