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  • Claim Form Cms-1500 - Anthem

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Mailing Address: Grievances & Appeals Department PO Box 60007 Los Angeles, CA 90060-0007 PDR form is found on www.anthem.com/ca >Provider Home>Answers@ Anthem>Provider Forms.

Log on to Anthem > My Plan and choose "Claims" from the drop-down menu. Scroll to the "Submit a Claim" button at the bottom of the page. Enter the requested contact and claims information and submit.

Currently, Anthem requires physicians to submit all professional claims for commercial and Medicare Advantage plans within 365 days of the date of service. Under the new requirement, all claims submitted on or after October 1, 2019, will be subject to the new 90 day filing requirement.

You can call Member Service at (855) 330-1106. If you purchased your plan through the Health Insurance Marketplace (exchange), please call Member Service at (855) 748-1808.

Click Billing > Enter Insurance Payment. For Payment Type, select Out-of-Network Insurance Payment. From the Payer dropdown, select the appropriate payer. Click the date(s) or service that the payment covers.

The CMS-1500 form is the standard claim form used by a non-institutional provider or supplier to bill Medicare carriers and durable medical equipment regional carriers (DMERCs) when a provider qualifies for a waiver from the Administrative Simplification Compliance Act (ASCA) requirement for electronic submission of ...

Mailing Address: Grievances & Appeals Department PO Box 60007 Los Angeles, CA 90060-0007 PDR form is found on www.anthem.com/ca >Provider Home>Answers@ Anthem>Provider Forms.

Mail original claims to BCBSIL, P.O. Box 805107, Chicago, IL 60680-4112.

Claims submitted after the claiming period will not be paid. If your claim is complete and you have forwarded all the necessary receipts and documents, your cheque will be mailed, or funds directly deposited into your account, approximately two weeks after we receive your claim.

Do one of the following. Click To-Do > Create CMS-1500 forms. Click Billing > Create CMS-1500. Click Payers > Payer Name > Payer Billing tab > Create CMS-1500. Under Search Billing Transactions, click the bold Pending Paper or Resubmit Paper link next to the date of service you want to bill for.

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© 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:
1-877-389-0141
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