Anthem Claim Dispute Form For Reimbursement In Georgia

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

Description

The Anthem claim dispute form for reimbursement in Georgia is a vital document for individuals seeking to resolve disputes related to health insurance claims with Anthem. This form allows users to formally contest claim decisions made by the insurance provider and request reimbursement for incurred expenses. Key features of the form include clear sections for detailing the nature of the claim, technical requirements for submission, and specific instructions for filling out required fields. Users can provide contextual information, such as dates and amounts owed, to support their claims. To effectively utilize the form, it is essential to carefully follow the provided guidelines for editing and submission. This form is particularly useful for attorneys, partners, owners, associates, paralegals, and legal assistants who assist clients in navigating health insurance issues. By accurately completing this form, legal professionals can enhance their clients' chances of successful reimbursement and settlement of claims. Additionally, the form helps streamline communication between the insurer and claimants, promoting efficiency in dispute resolution.

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FAQ

Since 2014, Anthem Blue Cross and Blue Shield of Georgia (Anthem) has provided medical claims administration and medical management services for the State Health Benefit Plan (SHBP).

-Timely filing is within 180 days of the date of service or per the terms of the provider agreement. Out-of-state and emergency transportation providers have 365 days from the last date of service.

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.

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.

Product and Program Contact Information Additional Contact Information Membership Address Blue Cross and Blue Shield of Illinois P.O. Box 3004 Naperville, IL 60566-9747 Claims Address Blue Cross and Blue Shield of Illinois P.O. Box 805107 Chicago, IL 60680-4112 Human Resources Inquiries 866-977-73782 more rows

To avoid delays in receiving payments, behavioral health claims should be submitted to: BlueCross BlueShield of Tennessee P.O. Box 180150 Chattanooga, TN 37420 Some plans use other vendors for behavioral health administration (see member ID card for details).

In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc.

Blue Cross and Blue Shield of Georgia has been providing quality health benefits for residents of Georgia for more than 70 years. Carry with you the medical ID card that signifies quality health care coverage and receive your healthcare from one of the largest physician networks in the state of Georgia.

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Anthem Claim Dispute Form For Reimbursement In Georgia