Our built-in tools help you complete, sign, share, and store your documents in one place.
Make edits, fill in missing information, and update formatting in US Legal Forms—just like you would in MS Word.
Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.
Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.
If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.
We protect your documents and personal data by following strict security and privacy standards.

Make edits, fill in missing information, and update formatting in US Legal Forms—just like you would in MS Word.

Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.

Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.

If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.

We protect your documents and personal data by following strict security and privacy standards.
Customer Care Centers Call 888-831-2246 Option 4 and ask to speak with Dr.
You may submit a grievance or an appeal online, by phone, by mail, or in person. Please review your Member Handbook (Evidence of Coverage) for guidelines on how to file a grievance or an appeal. Los Angeles: (800) 605-2556 (TTY: 711), 8 a.m. to 6 p.m., Monday through Friday.
If a dispute involves a lack of a decision, it must be submitted within 365 days, or the time specified in the provider's contract, whichever is greater, after the time for contesting or denying a claim has expired.
Blue Shield of California is a Registered® mark of the BlueCross BlueShield Association, an association of independent Blue Cross and Blue Shield plans. Blue Shield of California and Mylifepath are service marks of Blue Shield of California.
How to file a grievance or appeal. You may submit a grievance or an appeal online, by phone, by mail, or in person. Please review your Member Handbook (Evidence of Coverage) for guidelines on how to file a grievance or an appeal. Los Angeles: (800) 605-2556 (TTY: 711), 8 a.m. to 6 p.m., Monday through Friday.
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.
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.
For help, call us at the number listed on your ID card or 1-866-346-7198.