The parties may agree to a different performance. This is called an accord. When the accord is performed, this is called an accord and satisfaction. The original obligation is discharged. In order for there to be an accord and satisfaction, there must be a bona fide dispute; an agreement to settle the dispute; and the performance of the agreement. An example would be settlement of a lawsuit for breach of contract. The parties might settle for less than the amount called for under the contract.
Anthem Claim Dispute Form For Reimbursement In Queens
State:
Multi-State
County:
Queens
Control #:
US-00435BG
Format:
Word;
Rich Text
Instant download
Description
Form popularity
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. This information is part of the permanent record. Write clearly and legibly.
Fax: 800-964-3627. Phone: 800-450-8753.
Insurance: Anthem BCBS (formerly known as Empire Blue Cross Blue Shield BCBS) - NYC Health + Hospitals.
Yes. We will retain the Blue Cross and Blue Shield and Blue Cross in our name. Anthem Blue Cross and Blue Shield and Anthem Blue Cross are our local health insurance companies in our 14 Blue-licensed markets and will continue to be our local health plan brands in those states, which now includes New York.
Please complete the clinical sections on this form and attach it to your request at to ensure a timely review. Providers outside of Minnesota without electronic access can fax this form, along with clinical records to support the request, to (651) 662-2810.
You can also call a representative at 800-300-8181 (TTY 711), Monday through Friday from 8 a.m. to 8 p.m. and on Saturday from 9 a.m. to 5 p.m. Eastern time.
Blue Shield of California, 601 12th St, Oakland, CA 94607, US - MapQuest.
Send this claim to: Blue Shield of California, P.O. Box 272540, Chico, CA, 95927-2540.
Claims Submission LINE OF BUSINESSADDRESS Medi-Cal California Health and Wellness Plan Attn: Claims PO Box 4080 Farmington, MO 63640-3835
