Get Anthem Bcbs Provider Appeal Form

You or your provider can request an expedited appeal. Call Member Services toll-free at 844-912-0938 (TTY 711), Monday through Friday from 8 a.m. to 7 p.m. Eastern time. When we receive your call, we will call you within 72 hours to tell you our decision.

Grievance: Concerns that do not involve an initial determination (i.e. Accessibility/Timeliness of appointments, Quality of Service, MA Staff, etc.) Appeal: Written disputes or concerns about initial determinations; primarily concerns related to denial of services or payment for services.

The appeal must be received by Anthem Blue Cross (Anthem) within 365 days from the date on the notice of the letter advising of the action.

If there is a full or partial claim rejection or the payment is not the amount expected, submit a claims appeal. The appeal must be received by Anthem Blue Cross (Anthem) within 365 days from the date on the notice of the letter advising of the action.

What is a grievance? A grievance is a type of complaint that does not involve payment, denial or discontinuation of services by our health plan or our network providers. You might file a grievance if you have a problem with things such as: The quality of your care during a hospital stay.

Claim dispute From the Availity home page, select Claims & Payments from the top navigation. Select Claim Status Inquiry from the drop-down menu. Submit an inquiry and review the Claims Status Detail page. If the claim is denied or final, there will be an option to dispute the claim.

Claim dispute From the Availity home page, select Claims & Payments from the top navigation. Select Claim Status Inquiry from the drop-down menu. Submit an inquiry and review the Claims Status Detail page. If the claim is denied or final, there will be an option to dispute the claim.

Where can an appeal be filed? Call Member Services at 1-855-817-5785 (TTY: 711) Monday through Friday from 8 a.m. to 8 p.m. This call is free. Fax your written appeal to 1-888-458-1406.