Anthem Claim Dispute Form With Provider In Pima

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

Description

The Anthem claim dispute form with provider in Pima is designed to facilitate the resolution of disputes between healthcare providers and Anthem Insurance. This form allows providers to formally submit claims disputes, ensuring clear communication and documentation of the issues at hand. Key features of the form include detailed sections for describing the nature of the dispute, the specific claims involved, and the reasons for disputing them. Filling and editing instructions emphasize the importance of thorough and accurate completion to avoid delays in processing. It's essential for users to provide all necessary information to support their claims effectively. This form is particularly useful for attorneys, partners, owners, associates, paralegals, and legal assistants who work with healthcare claims and disputes. They can leverage this form to advocate for clients, ensuring that disputes are addressed in a structured manner. The form also serves as a safeguard for providers, documenting their position regarding disputed claims, which can be critical in negotiations or further legal actions.

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FAQ

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.

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

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

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

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.

Send this claim to: Blue Shield of California, P.O. Box 272540, Chico, CA, 95927-2540.

Anthem will consider reimbursement for the initial claim, when received and accepted within timely filing requirements, in compliance with federal, and/or state mandates. Anthem follows the standard of: • 90 days for participating providers and facilities. 15 months for nonparticipating providers and facilities.

Timely filing is when an insurance company put a time limit on claim submission. For example, if a insurance company has a 90-day timely filing limit that means you need to submit a claim within 90 days of the date of service.

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Anthem Claim Dispute Form With Provider In Pima