Anthem Claim Dispute Form For California In Travis

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

Description

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.

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FAQ

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.

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.

Case Management support is available 24/7 through Anthem Blue Cross Cal MediConnect Plan Customer Care at 1-855-817-5786.

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.

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.

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.

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.

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.

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.

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Anthem Claim Dispute Form For California In Travis