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  • Anthem Member Deletion Form

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Anthem Blue Cross and Blue Shield State Sponsored Business Provider Request for Member Deletion from Primary Medical Provider (PMP) Assignment A primary medical provider (PMP) may request disenrollment.

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Contact support

In Central California counties, please email CentralProviderRelationsMedicaid@anthem.com or call 1‑877‑811‑3113. In Northern California counties, please email NorthProviderRelationsMedicaid@anthem.com or call 1‑888‑252‑6331.

If you have questions related to Blue Shield Promise member's eligibility or benefits, contact Provider Services at (800) 468-9935.

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

call the Member Services phone number on the back of your ID card. send an email to ProviderDirectoryDiscrepancy@Anthem.com. call us at 1-844-839-4049.

Call Health Care Options at 1-844-580-7272, Monday through Friday from 8 a.m. to 6 p.m. TTY users should call 1-800-430-7077. Tell them you want to leave Anthem Blue Cross Cal MediConnect Plan and join a different Medi-Cal plan.

How to cancel Anthem Health Insurance Call customer service on 855-715-5316. Ask to speak with a representative. Provide them with your policy numbers and customer details. Request cancellation of your policy and monthly payments. You will receive a confirmation letter or email.

What do I include with my appeal? If your appeal is about a Part D drug: Your completed Redetermination Request Form. Your name, address and member ID number. Your reasons for appealing. Any information or evidence (documents, medical records) to support your appeal.

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© Copyright 1997-2025
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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
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
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:
1-877-389-0141
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