Anthem Claim Dispute Form With Provider In Virginia
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Find Virginia Health Coverage That Works for You Blue Cross Blue Shield Anthem Virginia is the largest health carrier in the state, with options to choose the best health plan based on your budget and care needs—whether online or in person.
Anthem Inc., a separate company from Premera that is also an independent licensee of the Blue Cross Blue Shield Association, recently suffered a cyber-attack which has been widely reported in the media.
In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield, and its affiliate HealthKeepers, Inc. trades as Anthem HealthKeepers providing HMO coverage, and their service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123.
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.
Anthem and Blue Cross Blue Shield are related, but they are not the same company. While they are both top health insurance providers in the USA, the big difference is that Blue Cross Blue Shield is the umbrella that is made up of several independent companies, and one of these smaller companies is Anthem.
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).
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.
