Anthem Claim Dispute Form With Decimals In Clark

State:
Multi-State
County:
Clark
Control #:
US-00435BG
Format:
Word; 
Rich Text
Instant download

Description

The Anthem claim dispute form with decimals in Clark is a legal document designed to facilitate the resolution of disputes between a creditor and a debtor. It outlines the agreement made between the parties regarding a disputed claim, detailing the payment to be made by the debtor and the specific claims being released by the creditor. This form is particularly useful for legal professionals as it provides a clear framework for documenting settlement terms, ensuring both parties understand their rights and obligations. Attorneys, partners, owners, associates, paralegals, and legal assistants can utilize this form to effectively manage disputes, paving the way for reduced litigation risks. Filling instructions are straightforward, guiding users to complete key fields such as dates, names, addresses, and details concerning the dispute. The simplicity of this form aids those with minimal legal experience, enabling them to navigate the settlement process confidently. This form can be beneficial in various scenarios, including debt disputes, contract negotiations, or settlement of financial claims. By employing the Anthem claim dispute form, users can achieve a more organized resolution process and foster better communication between disputing parties.

Form popularity

FAQ

Anthem BC CA Dental (Payer ID 47198)

Amerigroup Payer Name and ID: Your Payer Name is Amerigroup. Your Payer ID is 26375. Note: If you use a Billing Company or Clearinghouse for your EDI transmissions, please work with them on which payer ID they want you to use.

Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Blue Cross of California Partnership Plan, Inc. are independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

The payer ID is often located on the back of the insurance card in the Provider or Claims Submission section.

When complete, please mail to: Attn: Grievance and Appeals Department, Anthem Blue Cross, P.O. Box 60007, Los Angeles, CA 90060-0007. For claim disputes, please use the Provider Dispute Resolution form. This information is part of the permanent record. Write clearly and legibly.

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.

Payer Name and ID Your payer name is Anthem BC California and the payer ID is 47198 (If you use a billing company or clearinghouse for your EDI transmissions, please work with them on which payer ID they want you to use.)

Our clearinghouse uses payer ID BS001 for Blue Shield, and BC001 for Anthem Blue Cross. In addition to reaching out to the payer directly to confirm where claims need to be submitted, you can also use this Claims routing tool.

Yes. We will retain the Blue Cross and Blue Shield and Blue Cross in our name. Anthem Blue Cross and Blue Shield and Anthem Blue Cross are our local health insurance companies in our 14 Blue-licensed markets and will continue to be our local health plan brands in those states, which now includes New York.

Yes. We will retain the Blue Cross and Blue Shield and Blue Cross in our name. Anthem Blue Cross and Blue Shield and Anthem Blue Cross are our local health insurance companies in our 14 Blue-licensed markets and will continue to be our local health plan brands in those states, which now includes New York.

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Anthem Claim Dispute Form With Decimals In Clark