We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • More Forms
  • More Uncategorized Forms
  • Short-term Disability Claim Form - Anthem

Get Short-term Disability Claim Form - Anthem

Your physician complete Section 3. Submit the form to us at the address or fax number listed below. Your cooperation will facilitate payments promptly when they are due. Any person who knowingly, and with intent to defraud any insurance company, files a statement of claim containing any false, incomplete or misleading information may be subject to criminal penalties. Clear Form Anthem Life Insurance Company Disability Claims Service Center P.O. Box 105426 Atlanta, GA 30348-5426 Phone: 800-81.

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

Tips on how to fill out, edit and sign Short-Term Disability Claim Form - Anthem online

How to fill out and sign Short-Term Disability Claim Form - Anthem online?

Get your online template and fill it in using progressive features. Enjoy smart fillable fields and interactivity.Follow the simple instructions below:

Experience all the benefits of completing and submitting forms on the internet. Using our solution completing Short-Term Disability Claim Form - Anthem only takes a couple of minutes. We make that achievable through giving you access to our feature-rich editor effective at altering/fixing a document?s initial textual content, inserting special fields, and putting your signature on.

Fill out Short-Term Disability Claim Form - Anthem in several clicks by simply following the recommendations listed below:

  1. Select the document template you will need from our library of legal form samples.
  2. Click the Get form key to open it and begin editing.
  3. Fill in the required fields (they are marked in yellow).
  4. The Signature Wizard will help you insert your e-signature as soon as you have finished imputing data.
  5. Put the relevant date.
  6. Check the entire template to be certain you have filled out everything and no corrections are needed.
  7. Press Done and save the ecompleted document to the computer.

Send your Short-Term Disability Claim Form - Anthem in an electronic form when you finish completing it. Your data is well-protected, because we keep to the latest security standards. Become one of numerous satisfied clients that are already submitting legal documents right from their houses.

How to edit Short-Term Disability Claim Form - Anthem: customize forms online

Sign and share Short-Term Disability Claim Form - Anthem together with any other business and personal documents online without wasting time and resources on printing and postal delivery. Take the most out of our online form editor using a built-in compliant eSignature option.

Approving and submitting Short-Term Disability Claim Form - Anthem documents electronically is quicker and more effective than managing them on paper. However, it requires employing online solutions that guarantee a high level of data safety and provide you with a compliant tool for generating electronic signatures. Our powerful online editor is just the one you need to complete your Short-Term Disability Claim Form - Anthem and other personal and business or tax templates in a precise and proper way in line with all the requirements. It features all the necessary tools to easily and quickly fill out, edit, and sign documentation online and add Signature fields for other people, specifying who and where should sign.

It takes just a few simple steps to fill out and sign Short-Term Disability Claim Form - Anthem online:

  1. Open the chosen file for further processing.
  2. Utilize the top toolkit to add Text, Initials, Image, Check, and Cross marks to your template.
  3. Underline the important details and blackout or remove the sensitive ones if required.
  4. Click on the Sign option above and decide on how you prefer to eSign your form.
  5. Draw your signature, type it, upload its picture, or use another option that suits you.
  6. Move to the Edit Fillable Fileds panel and drop Signature areas for others.
  7. Click on Add Signer and provide your recipient’s email to assign this field to them.
  8. Check that all data provided is complete and accurate before you click Done.
  9. Share your form with others utilizing one of the available options.

When approving Short-Term Disability Claim Form - Anthem with our powerful online solution, you can always be certain you get it legally binding and court-admissible. Prepare and submit documentation in the most effective way possible!

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

Anthem Life & Disability Insurance Company...
Dec 31, 2013 — ANTHEM LIFE AND DISABILITY INSURANCE COMPANY ... of short term disability...
Learn more
Quick Reference - Human Resources - Purdue...
Medical. Anthem Blue Cross Blue Shield ... Long Term & Short Term Disability ... HIPPA...
Learn more
Luxembourg - Wikipedia
Luxembourg officially the Grand Duchy of Luxembourg, is a landlocked country in Western...
Learn more

Related links form

General Assembly Of North Carolina Session 2009 Session Law ... Site Supervisor's Evaluation Of Service-Learning Students 2007-2008 - Felician College - Felician STUDENT 2012-2013 STUDENT EXPENSE ... - Felician College - Felician

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

Payer Name and ID 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.)

Accidental Death And Dismemberment. Our group accidental death and dismemberment (AD&D) insurance provides additional benefits for losses from accidents.

Dedicated Provider appeals line: Phone:(800) 541-6652. HMO and PPO: Blue Shield of California Initial Appeal Resolution Office. P.O. Box 272620. Chico, CA 95927-2620. Blue Shield 65 Plus (HMO): Blue Shield 65 Plus. Medicare Provider Appeals Department. P.O. Box 272640. Chico, CA 95927-2640. Fax: (855) 895-3501.

Request a Payer Payer IDPayer Name84105Blue Cross Blue Shield of Missouri84105Blue Cross Blue Shield of Maine (Anthem)84105BCBS ME84105Blue Cross Blue Shield of ME16 more rows

The Payer ID or EDI is a unique ID assigned to each insurance company. It allows provider and payer systems to talk to one another to verify eligibility, benefits and submit claims. The payer ID is generally five (5) characters but it may be longer. It may also be alpha, numeric or a combination.

Care Management support is available 24/7 through Anthem Blue Cross Cal MediConnect Plan Customer Care at 1-855-817-5786.

Submit A Claim If your group has short-term disability telephonic claim intake, call us at 800-232-0113 to start your claim.

How To Submit An Anthem Claim Yourself Make sure the claim form from your benefits plan includes all required information, especially procedure codes (you can receive these from your doctor's office). If you're filling the form out by hand, write legibly. File your paperwork promptly and within the time limit.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get Short-Term Disability Claim Form - Anthem
Get form
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232