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Get Anthem Blue Cross Provider Dispute Form 2009-2024

On Form, provided later in this section. Local Providers have one year from the date of the original explanation of benefits (EOB) or remittance advice (RA) to appeal a claims adjudication action. This policy does not apply to routine provider inquiries that Anthem resolves in a timely fashion through existing informal processes (i.e., through customer service or submission of a Claim Action Request Form). National Accounts Providers appeals time limits are based on time limits listed in the Pro.

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