Anthem Claim Dispute Form With Provider In Oakland

State:
Multi-State
County:
Oakland
Control #:
US-00435BG
Format:
Word; 
Rich Text
101 downloads

Description

The Anthem claim dispute form with provider in Oakland is a crucial document designed for resolving disputes between healthcare providers and Anthem regarding claims. This form allows users to officially register their disagreement concerning claims denied or underpaid by Anthem. Key features include sections for detailed explanations of the dispute, including specific claims and the rationale behind the disagreement. Users should fill in the relevant parties' information, specify the nature of the dispute, and clarify the claims being contested. This form streamlines communication and ensures that all stakeholders have a clear understanding of the issues at hand. Attorneys, partners, owners, associates, paralegals, and legal assistants may find this form particularly useful for ensuring compliance with due process and legal standards in healthcare disputes. Proper editing and detailing in the form can significantly enhance the chances of a favorable outcome. It is essential for users to remain concise yet thorough in their explanations, as clarity can aid in quicker resolutions.

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FAQ

For help, call us at the number listed on your ID card or 1-866-346-7198.

Case Management for Anthem Blue Cross Cal MediConnect Plan Case Management support is available 24/7 through Anthem Blue Cross Cal MediConnect Plan Customer Care at 1-855-817-5786.

Effective Date: January 1, 2024 Plan NameSingle (1)Two-Party (2) Anthem Blue Cross Del Norte EPO $1,240.19 $2,480.37 Anthem Blue Cross Select HMO $944.08 $1,888.16 Anthem Blue Cross Traditional HMO $1,221.90 $2,443.80 Blue Shield Access+ EPO $910.34 $1,820.6815 more rows •

Anthem follows the standard of: • 180 days for participating providers and facilities. 210 days for nonparticipating providers and facilities. Timely filing is determined by subtracting the date of service from the date we receive the claim and comparing the number of days to the applicable federal or state mandate.

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.

Phone: 800-977-2273 (TTY 711)

Anthem Blue Cross is the trade name of In California: Blue Cross of California, Anthem Blue Cross Partnership Plan, Anthem BC Health Insurance Company and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association.

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.

Customer Care Centers Call 888-831-2246 Option 4 and ask to speak with Dr.

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Anthem Claim Dispute Form With Provider In Oakland