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 Medication In Virginia
State:
Multi-State
Control #:
US-00435BG
Format:
Word;
Rich Text
Instant download
Description
Form popularity
FAQ
One redetermination form can be submitted for multiple claims only for denials by the Unified Program Integrity Contractor or Medical Review probe reviews. Fax request to 1-888-541-3829.
Please fax to 1-855-516-1083. You may ask us to rush your appeal if your health needs it. We'll let you know we got your appeal within 24 hours from the time we received it.
File the appeal within ten (10) days from the date your "Determination of Eligibility" was sent by one of these methods: Mail the appeal to 10 North Senate Avenue, Indianapolis, IN 46204; Fax the appeal to (317) 233-6888; Deliver the appeal in person to the Department at 10 N.
Corrected claims must be received within 12 months of Explanation of Payment (EOP). Appeal deadlines: Claim payment reconsideration must be filed within 12 months of the EOP. Claim payment appeals must be filed within 15 months of service or 180 days from the reconsideration decision.
After you fill out the form, Mail/Fax/deliver your request for a hearing within 33 days of the date of the notice you are appealing. Mail: FSSA Document Center PO Box 1810 Marion, Indiana 46952 Fax: 1-800-403-0864 Visit your local DFR/Medicaid Office.
You can also fax to 855-516-1083. Please be sure to mark "EXPEDITED" on the form before faxing.
Anthem follows the standard of: • 90 days for participating providers and facilities. 180 days for nonparticipating providers and facilities (For dates of service prior to January 1, 2019, 12 months for nonparticipating providers).
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.
Corrected claims and appeals have shorter deadlines, typically within 60-180 days of denial or payment.
