Los Angeles Anthem Health Insurance Claims Process
When you or your provider submits a claim to Anthem, you anticipate that the process will progress in a timely manner and that your claim will be covered. Unfortunately, for many Anthem policyholders, this is not always the case.
The Los Angeles Anthem health insurance claims process can be complex and burdensome, especially for those without experience in the industry. If you are having trouble with a denied claim or with the Anthem claims process, you may benefit from speaking to an experienced insurance denials attorney who regularly fights denied claims and knows what to do.
What is the Anthem Claims Process?
Each insurance company has their own claims process. As long as it follows both federal and California Insurance Code, Anthem can set up their claims process in any way that they choose. Patients can elect to file a claim on their own or, if their provider does insurance billing, to have the medical provider submit the claim directly to Anthem. If the provider is familiar with the Anthem claims process, there is usually nothing further for the claimant to do.
If the applicant will be submitting the claim on their own, they will usually have to fill out a claim form. This form will ask for personal details, contact information, provider information, and what services were performed. It will also ask whether the medical care was in relation to any type of accident.
No matter which way a claim is submitted, the Anthem health insurance claims process in Los Angeles can lead to denied claims. A simple typo or other clerical error such as the wrong billing code or date of birth can lead to a denial. Not enough supportive information or details on a claim form can also be a reason for denial.
Deadline to Respond in Los Angeles
Anthem is legally required to respond to a non-urgent health insurance claim with an acceptance or denial within 40 days of receipt. All health insurance companies are also required to clearly document in the claim file the amounts of the claim that are being accepted or denied unless the entire claim is being denied.
If a claimant does not receive a response from Anthem within the 40-day time period, they may want to consider contacting an attorney for help. A seasoned lawyer can help them fight the denial and guide them through the process to give them the greatest chance of success.
Get Help with the Los Angeles Anthem Health Insurance Claims Process
In order to successfully navigate the Los Angeles Anthem health insurance claims process, you may want to turn to a well-versed insurance attorney. They know the tactics that Anthem uses in order to avoid or delay paying on a claim. They can help you submit your claim correctly the first time and hold Anthem accountable to respond to your claim in a timely fashion.
If your claim is subsequently denied, they can help you with the next steps such as an appeal or a lawsuit. Call today for diligent guidance throughout the Los Angeles Anthem health insurance claims process.