Anthem Claim Dispute Form With Provider In Wayne
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If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.
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FAQ
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.
Currently, Anthem requires physicians to submit all professional claims for commercial and Medicare Advantage plans within 365 days of the date of service. Under the new requirement, all claims submitted on or after October 1, 2019, will be subject to the new 90 day filing requirement.
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.
Anthem follows the standard of: • 90 days for participating providers and facilities.
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.
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.
Members have up to 180 calendar days from the date of an incident or dispute, or from the date the member receives a denial letter, to submit a grievance or appeal to Anthem Blue Cross.
