A New Look to the Payment Integrity Program Webpage

We have redesigned the Payment Integrity Program (PIP) webpage to make the information easier to navigate. This page has been moved and can now be found under the “Eligibility & Claims” section, and Payment Integrity Program.

Screenshot of payment integrity program in mega menu

Along with the content layout change, information has been added regarding reviews level 4 and 5 E/M services, as well as an update to the denial resolution grid.

We encourage providers to utilize this information to aid in their review and reconsideration request submissions related to Payment Integrity.

For more questions, please contact the Provider Service number listed on the back of the member's ID card.