Anthem Claim Dispute Form With Email In Salt Lake

State:
Multi-State
County:
Salt Lake
Control #:
US-00435BG
Format:
Word; 
Rich Text
Instant download

Description

The Anthem claim dispute form with email in Salt Lake serves as a legal document allowing parties to formalize an agreement regarding a disputed claim. This form is designed for use by both creditors and debtors to outline specific claims and the terms of settlement. Key features include sections for documenting the date of the agreement, the identities of the parties involved, and detailed descriptions of the claims being disputed, including any denials offered by the debtor. It ensures that all claims are clearly defined and that both parties acknowledge the terms of the resolution. For users such as attorneys, partners, owners, associates, paralegals, and legal assistants, this form is essential when negotiating settlements to avoid protracted litigation. Completing the form involves entering relevant details and signatures, which can typically be done electronically for convenience. This form also serves as a record to protect both parties from future disputes related to the same claims. Clarity in filling out the information ensures that both parties have a mutual understanding of the agreement, reducing the likelihood of misunderstandings post-signing.

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FAQ

Your payer name is Anthem BC California and the payer ID is 47198 (If you use a billing company or clearinghouse for your EDI transmissions, please work with them on which payer ID they want you to use.) Questions? We're here to help.

For help, call us at the number listed on your ID card or 1-866-346-7198.

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.

Medi-Cal Managed Care (Medi-Cal) Anthem Blue Cross is the trade name of Blue Cross of California.

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

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. This information is part of the permanent record. Write clearly and legibly.

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

Providers: Telephone Service Center: (800) 541-5555. Provider-Telecommunications Network (PTN): (800) 786-4346. Out-of-State Provider Support: (916) 636-1960.

The organization is now headquartered in Oakland, California, with over 4.8 million members. While focusing primarily on individuals, families and businesses within the state. Blue Shield is part of a broader network of Blue Cross Blue Shield (BCBS) companies operating nationwide.

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Anthem Claim Dispute Form With Email In Salt Lake