Anthem Claim Dispute Form With Provider In San Diego

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

Description

The Anthem claim dispute form with provider in San Diego is designed to facilitate the resolution of disputes between healthcare providers and Anthem regarding claims. This form allows users to formally present disputes, ensuring that all relevant information is documented for review. Key features include sections for detailing the nature of the dispute, the basis for the claim, and specific requests for resolution. Filling out the form requires clear and concise information to support the dispute. Editing instructions encourage users to double-check all entries for accuracy before submission. This form is particularly useful for attorneys, partners, owners, associates, paralegals, and legal assistants, as it assists in the organization and presentation of claims, promotes effective communication, and helps to expedite the dispute resolution process. Proper utilization of the form can enhance clients’ outcomes by ensuring thorough and documented disputes are presented to Anthem.

Form popularity

FAQ

With the PPO, you can use any of the BCBS providers in all 50 states. They may not be directly contracted with the BS of CA, but as long as they participate with the BCBS in the state you see a provider in, they will file claims with that plan. Benefits would be covered at the in-network rates given that's the case.

Effective January 1, 2024, Anthem Blue Cross (Anthem) will exit 14 counties listed here: Alameda, Butte, Colusa, Contra, Costa Glenn, Mariposa, Nevada, Placer, Plumas, San Benito, Sierra, Sutter, Tehama, and Yuba.

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.

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.

Blue Shield sold Care1st Arizona to WellCare in 2017. Care1st California was renamed Blue Shield of California Promise Health Plan in 2019.

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

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.

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.

Set the billing frequency to either Replacement of Prior Claim or Void/Cancel of Prior Claim in the Claim Information section (for professional and facility claims). You will use Replacement of Prior Claim if the claim has been processed and Void/Cancel of Prior Claim if the claim is still in processing.

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Anthem Claim Dispute Form With Provider In San Diego