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
  • Social Forms
  • Virginia Social Forms
  • Va Anthem Form 151 2014

Get Va Anthem Form 151 2014-2025

Claim Information/Adjustment Request 151 Form Please Mail Form To P. O. Box 27401 Richmond VA 23279-7401 For Federal Employee Program use P. O. Box 105557 Atlanta GA 30348-5557 Provider Please complete all sections of this form to assist us when researching your inquiry/adjustment request. Insured s ID Number Claim Filed Paper as shown on Patient s ID card Claim Type Professional Patient s Name Electronic Patient s Account Number Facility Date Sent Dental Other Insurance if applicable to inquiry Claim Number Charge Please Return To Insurance Company Name Telephone Number Policy Number Effective Date Name of Referring Physician Provider s Name and Address Certification Number Dates of Service Home Other Inpatient Hospital Office Place of Treatment PLEASE DESCRIBE Outpatient Hospital Group Name or Number Reason Additional Information Attached Adjustment Request Overpayment Other Explain Underpayment Onset Date // Check Appropriate Box Consult Date // LMP Accident Illness first symptom 83....

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

How to fill out the VA Anthem Form 151 online

The VA Anthem Form 151 is essential for submitting claim information and requesting adjustments. This guide provides clear and user-friendly instructions to assist you in completing this form online.

Follow the steps to fill out your VA Anthem Form 151 online.

  1. Press the ‘Get Form’ button to acquire the form and open it for editing.
  2. In the first section, enter the insured's ID number as it appears on the patient's ID card. This is crucial for identifying the appropriate account.
  3. Indicate the type of claim filed by selecting one of the options: Paper or Electronic.
  4. Fill in the patient's name and account number. Ensure accuracy to streamline processing.
  5. Specify the date the claim was sent and select the claim type (e.g., professional, dental, facility, etc.).
  6. If applicable, provide information for other insurance by entering the insurance company name, insured's name, telephone number, and policy number.
  7. Input the effective date and the name of the referring physician if relevant.
  8. In the provider’s section, include the provider's name and address, along with the certification number.
  9. Document the dates of service and select the place of treatment by checking the appropriate box.
  10. In the reason section, briefly describe the claim issue and action required. Select whether it is an adjustment request for overpayment or underpayment.
  11. Include the onset date and consult date if relevant. Fill in the 837 attachment control number.
  12. Once you have completed all sections, review the form for accuracy. You can then save your changes, download, print, or share the completed form.

Complete your VA Anthem Form 151 online today for a seamless claim process.

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 Health Plans of Virginia, Inc. trades as...
When you submit a Claims Information and Adjustment. Request Form (151), please be sure to...
Learn more
Anthem PPO Plan PPO Network University of...
by APPO Plan — This Benefit Booklet gives you a description of your benefits while you...
Learn more
LTX-500
Informazioni per gli utenti sullo smaltimento delle apparecchiature e batterie obsolete...
Learn more

Related links form

VA DPOR F701-COMPFRM 2017 VA ERFC-29A 2016 VA ERFC29B 2018 VA FS-152 - Fairfax County 2018

Questions & Answers

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

Contact support

Yes, Anthem HealthKeepers operates as a Medicaid managed care plan in Virginia. This plan is designed to give eligible members access to a comprehensive range of health services. If you are covered under this plan, it is vital to understand the requirements for claims filing, including using the VA Anthem Form 151 when needed. To navigate these requirements smoothly, check out the resources available on uslegalforms.

The VA timely filing limit generally refers to the requirement of submitting claims within 180 days after the service date. This policy applies to most claims submitted to Anthem and is crucial for ensuring you receive the payments owed for services provided. By keeping track of this timeline, you protect your practice and secure timely reimbursements. For additional assistance with claims filing, the uslegalforms platform can be a helpful resource.

The timely filing limit for Anthem VA mirrors the standard limit of 180 days from the date of service. This time frame applies to all claims submitted for processing and payment. Being aware of this limit allows you to track your claims more effectively and avoid unnecessary denials. To optimize your claims management, explore the solutions offered by uslegalforms, which may help streamline your filing process.

Yes, some individuals have received settlements from Blue Cross Blue Shield as part of class action agreements or individual claims. The amounts vary based on numerous factors including the nature of the claims and compliance with submission guidelines. Using the VA Anthem Form 151 may enhance your opportunity to receive a fair settlement. If you're navigating this process, consider reaching out to platforms like uslegalforms for assistance with your claims.

The lawsuit against Anthem Blue Cross centers around allegations of wrongful denial of claims and misleading policy practices. Many policyholders have come forward to seek justice and compensation for their experiences. If you find yourself impacted by this situation, the VA Anthem Form 151 can be instrumental. This form will help ensure that your claims are properly documented and submitted for consideration.

The class action lawsuit against Anthem involves claims that the company engaged in unfair practices impacting policyholders. It seeks to address grievances from numerous individuals who believe their claims were improperly handled. Understanding how the VA Anthem Form 151 fits into this context is essential for those affected. This form allows members to participate and assert their rights within the ongoing legal proceedings.

The amount each person will receive in the BCBS settlement depends on various factors, such as the specific claims submitted and the overall settlement agreement. Typically, individuals must submit the VA Anthem Form 151 to claim their compensation. This form ensures that all necessary information is provided to facilitate the claims process. Staying informed about the status of the settlement can help you understand what to expect.

The timely filing limit for Anthem corrected claims generally extends to 12 months from the original service date. Submitting corrected claims promptly is crucial for efficient processing. Take note of this time limit when dealing with your VA Anthem Form 151 to avoid potential delays.

In Virginia, Anthem operates under the name Anthem Blue Cross Blue Shield. They provide various health insurance products and services tailored to meet the needs of Virginians. For additional queries regarding their services, having your VA Anthem Form 151 on hand can enhance your communication and support experience.

The Anthem Claim Information Adjustment Request 151 form is used to request adjustments on previously submitted claims. This form addresses issues such as denials or payment discrepancies. If you encounter such a situation, using the VA Anthem Form 151 can help you navigate the claims adjustment process effectively.

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 VA Anthem Form 151
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
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
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 WorkFlow
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
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
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 WorkFlow
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