Anthem Claim Dispute Form For Providers In Fulton
Description
Form popularity
FAQ
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.
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.
You can also fax to 855-516-1083. Please be sure to mark "EXPEDITED" on the form before faxing.
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.
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.
3350 Peachtree Road, N.E., P.O. Box 4445, Atlanta, GA 30302 As You read through it, remember "We", "Us" and "Our" refer to Blue Cross Blue Shield Healthcare Plan of Georgia. We use the words "You” and "Your" to mean each covered Member.
How to Find Timely Filing Limits With Insurance Insurance CompanyTimely Filing Limit (From the date of service) Anthem BCBS Ohio, Kentucky, Indiana, Wisconsin 90 Days Wellmark BCBS Iowa and South Dakota 180 Days BCBS Alabama 2 Years BCBS Arkansas 180 Days28 more rows
Original (or initial) Medi-Cal claims must be received by the California MMIS FI within six months following the month in which services were rendered. This requirement is referred to as the six-month billing limit.
Claim forms are available by logging into the member website at blueshieldca or by contacting the benefit administrator. Please submit your claim form and medical records within one year of the service date.
