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Agreement for Accord and Satisfaction of a Disputed Claim

Anthem Claim Dispute Form With 2 Points In Clark

Q: What is the timely filing limit for Anthem Blue Cross of California?

Anthem follows the standard of: 90 days for participating providers and facilities. 15 months for nonparticipating providers and facilities.

Category:

Civil Procedure - Accord and Satisfaction

State:

Multi-State

County:

Clark

Control #:

US-00435BG

Format:

Instant download

Description

The Anthem claim dispute form serves as a formal agreement between a creditor and a debtor regarding the resolution of a disputed claim. This document includes a section for the parties to specify the nature of the claim, along with the reasons for denial by the debtor. One key feature of the form is its structure, which clearly delineates the obligations of both parties and provides a legally binding resolution to disputes. Filling out the form requires accurate identification of both parties and details regarding the claim and the amount to be paid. Legal professionals such as attorneys, partners, and paralegals can utilize this form to formalize settlements and ensure clear documentation of disputes and resolutions. Furthermore, it’s beneficial for associates and legal assistants who might need to assist in drafting or reviewing such agreements. This form is particularly relevant when clients seek to resolve claims without proceeding to litigation, making it an essential tool for efficient dispute resolution within the legal field.

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FAQ

Anthem follows the standard of 365 days for participating and nonparticipating providers and facilities. Timely filing is determined by subtracting the date of service from the date we receive the claim and comparing the number of days to the applicable federal or state mandate.

When complete, please mail to: Attn: Grievance and Appeals Department, Anthem Blue Cross, P.O. Box 60007, Los Angeles, CA 90060-0007. For claim disputes, please use the Provider Dispute Resolution form.

Send this claim to: Blue Shield of California, P.O. Box 272540, Chico, CA, 95927-2540.

Customer Care Centers Call 888-831-2246 Option 4 and ask to speak with Dr.

Is Anthem the same as Blue Cross Blue Shield? Anthem is part of the Blue Cross Blue Shield group. Blue Cross Blue Shield is made up of independent companies. Anthem is one of these companies.

The appeal must be received by Anthem Blue Cross (Anthem) within 365 days from the date on the notice of the letter advising of the action.

Anthem follows the standard of: • 90 days for participating providers and facilities. 15 months for nonparticipating providers and facilities.

Members have up to 180 calendar days from the date of an incident or dispute, or from the date the member receives a denial letter, to submit a grievance or appeal to Anthem Blue Cross.