The parties may agree to a different performance. This is called an accord. When the accord is performed, this is called an accord and satisfaction. The original obligation is discharged. In order for there to be an accord and satisfaction, there must be a bona fide dispute; an agreement to settle the dispute; and the performance of the agreement. An example would be settlement of a lawsuit for breach of contract. The parties might settle for less than the amount called for under the contract.
Anthem Claim Dispute Form With 2 Points In Broward
State:
Multi-State
County:
Broward
Control #:
US-00435BG
Format:
Word;
Rich Text
Instant download
Description
Form popularity
FAQ
Please fax to 1-855-516-1083. You may ask us to rush your appeal if your health needs it. We'll let you know we got your appeal within 24 hours from the time we received it.
One redetermination form can be submitted for multiple claims only for denials by the Unified Program Integrity Contractor or Medical Review probe reviews. Fax request to 1-888-541-3829.
After you fill out the form, Mail/Fax/deliver your request for a hearing within 33 days of the date of the notice you are appealing. Mail: FSSA Document Center PO Box 1810 Marion, Indiana 46952 Fax: 1-800-403-0864 Visit your local DFR/Medicaid Office.
File the appeal within ten (10) days from the date your "Determination of Eligibility" was sent by one of these methods: Mail the appeal to 10 North Senate Avenue, Indianapolis, IN 46204; Fax the appeal to (317) 233-6888; Deliver the appeal in person to the Department at 10 N.
Anthem and Blue Cross Blue Shield are related, but they are not the same company. While they are both top health insurance providers in the USA, the big difference is that Blue Cross Blue Shield is the umbrella that is made up of several independent companies, and one of these smaller companies is Anthem.
Anthem follows the standard of: • 90 days for participating providers and facilities. 15 months for nonparticipating providers and facilities.
You can also fax to 855-516-1083. Please be sure to mark "EXPEDITED" on the form before faxing.
More info
If the claim is denied or final, there will be an option to dispute the claim. Select Dispute the Claim to begin the process.If you disagree with the outcome of a claim, you may begin the Anthem Blue Cross and Blue Shield (Anthem) provider claims dispute process. Use Availity to submit claims, check the status of all your claims, appeal a claim decision and much more. The Dispute Resolution Program is a statutorily created program to assist health care providers and health insurance plans resolve health care claims disputes. Please complete the form below. When filing a paper claim, the physician or provider's handwritten signature (or signature stamp) must be in the appropriate block of the claim form (box 31).
