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3500 Civil Procedure Forms
Multi-State
Agreement for Accord and Satisfaction of a Disputed Claim

Anthem Claim Dispute Form With Provider In Phoenix

Category:

Civil Procedure - Accord and Satisfaction

State:

Multi-State

City:

Phoenix

Control #:

US-00435BG

Format:

Instant download

Description

The Anthem claim dispute form with provider in Phoenix is designed to facilitate the resolution of disputes between healthcare providers and Anthem insurance regarding claims. This form allows providers to dispute claims that they believe have been improperly denied or underpaid, streamlining the appeals process. Key features of the form include sections for detailing the nature of the claim, the specific reasons for the dispute, and relevant payment information. Users are instructed to complete the form accurately and provide thorough explanations to support their claims. Filling this form involves clearly stating the claim details alongside supporting documentation for best results. Attorneys, partners, owners, associates, paralegals, and legal assistants will find this form useful in advocating for their clients' rights to proper payment and fair treatment from insurance companies. The form serves as a critical tool in dispute resolution, ensuring that healthcare providers can effectively address and rectify claim issues.

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FAQ

-Timely filing is within 180 days of the date of service or per the terms of the provider agreement. Out-of-state and emergency transportation providers have 365 days from the last date of service.

Timely filing is when an insurance company put a time limit on claim submission. For example, if a insurance company has a 90-day timely filing limit that means you need to submit a claim within 90 days of the date of service.

How to Find Timely Filing Limits With Insurance Insurance CompanyTimely Filing Limit (From the date of service) Anthem BCBS Ohio, Kentucky, Indiana, Wisconsin 90 Days Wellmark BCBS Iowa and South Dakota 180 Days BCBS Alabama 2 Years BCBS Arkansas 180 Days28 more rows

180-day timely filing limit.

Anthem will consider reimbursement for the initial claim, when received and accepted within timely filing requirements, in compliance with federal, and/or state mandates. Anthem follows the standard of: • 90 days for participating providers and facilities. 15 months for nonparticipating providers and facilities.