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 With 2 Points In San Bernardino
State:
Multi-State
County:
San Bernardino
Control #:
US-00435BG
Format:
Word;
Rich Text
Instant download
Description
Form popularity
FAQ
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.
Simply put, you can appeal if you think there is a logical and acceptable reason why the claim was false. It would probably be denied if there was no way to submit the claim within the time limit However, if you have a valid reason, this denial could get overturned, and your claim might be accepted.
Original (or initial) Medi-Cal claims must be received by the California MMIS FI within six months following the month in which services were rendered. This requirement is referred to as the six-month billing limit.
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.
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.
Claim forms are available by logging into the member website at blueshieldca or by contacting the benefit administrator. Please submit your claim form and medical records within one year of the service date.
If you think we have made a mistake in denying your medical service, or if you don't agree with our decision, you can ask for an appeal. You must do this within 60 calendar days from the date on the Notice of Action sent to you. We will resolve your concerns within 30 days of receiving your complaint.
You need to file your appeal within 60 calendar days from the date on the coverage determination/organization determination notice (denial letter) you received.
Blue Shield sold Care1st Arizona to WellCare in 2017. Care1st California was renamed Blue Shield of California Promise Health Plan in 2019.
