Anthem Workers Compensation Phone Number

How To File A Lien - California Department Of Industrial ...
A Workers’ Compensation Appeals Board (WCAB) case number must be entered in workshop for injured workers. The local I&A phone numbers are attached to this The lien claimant hereby requests the Workers' Compensation Appeals Board to determine and allow as a lien the sum ... Access Document

Anthem Life Administered By - Bay Bridge Administrators, LLC
Disclosures Anthem Life Insurance Company Bay Bridge Administrators, LLC. P.O. Box 161690 Your Present Address Social Security Number Phone No. ( ) Height Weight Male Female have you filed a Workers' Compensation Claim? ... Get Content Here

Member Claim Form
Anthem Blue Cross Plan by the provider of service (the physician, Have you filed for Workers’ Compensation The phone number and/or address can be found on your Anthem Blue ... Read Document

Claims And Correspondence Mailing Addresses
Anthem Blue Cross Workers’ Compensation Managed Care Services 2170 Towne Center Drive, Suite 320 Anaheim, CA 92806 Senior Secure claims and claims-related correspondence Anthem Blue Cross /Senior Secure and phone number, including extension ... Fetch Content

Blue Cross MedicareRx (PDP) With Senior Rx Plus Employer ...
Home phone number ( ) Alternate phone number ( ) Permanent residence Workers Compensation, VA bene ts or from state pharmaceutical assistance programs. Anthem Blue Cross Life and Health Insurance Company (Anthem) ... Fetch Content

2-50 Small Group Employer Application
This is based upon the total number of employees during 50% of working days in the Current Workers’Compensation carrier: _____ Next Renewal Date:(mm/dd/yy) _____ List name and Phone No. Fax No. Writing Agent’s Signature Date Name of Second Writing Agent ... Fetch Content

Member Claim Form - Human Resources | County Of Sonoma
POLICY NUMBER SUBSCRIBER INFORMATION (on Anthem Blue Cross Card) CERTIFICATE NUMBER GROUP NUMBER NAME Last First Middle Initial ADDRESS CITY STATE ZIP CODE HOME PHONE NO. WORK PHONE NO. ( )( ) MEDICAL INFORMATION Have you filed for Workers’ Compensation ... Read More

Covered Employee Notification Of Rights Materials
Anthem Blue Cross contracts with doctors, name, address and phone number of the physician you have selected. Workers’ Compensation Medical Unit of the State of California. To request an IMR you will be required to complete ... Access Content

PALOMAR COLLEGE Worker’s Compensation Notice
We provide workers’ compensation benefits, which include through selected Anthem Blue Cross Prudent Buyer PPO (“Blue Cross of California”) providers. name, address and phone number of the physician you have selected. ... Document Retrieval

Pre-Authorization Request Form - WPS | Wisconsin Health Insurance
Member Number: Provider Fax #: Date of Birth: Provider Phone #: Contact Name: Ordering Physician: Place of Service/Treatment and Address: Physician’s Address: Service q Yes q No Is this Workers’ Compensation related? ... Get Document

Telephone Numbers And Mailing Addresses
The Home plan’s location and phone number may be obtained from the member’s card. Workers’ Compensation and Right to Recovery Inquiries: 1-800-345-2227 Anthem UM will issue a case number to the facility case manager/discharge planner for your reference. ... Read Here

Employer Application BeneFits From Anthem Blue Cross
Date Business Established (Mo/Yr) Company Contact Person Phone No. Fax No. A. Total number of employees (including owners/officers): _____ 12. Please tell us about your Workers’ Compensation coverage: ... Return Doc

Member Claim Form - Medicoverage - Affordable Health ...
POLICY NUMBER HOME PHONE NO. WORK PHONE NO. MEDICAL INFORMATION PATIENT INFORMATION SUBSCRIBER INFORMATION (on Anthem Blue Cross Card) Member Claim Form Have you filed for Workers’ Compensation ... Doc Retrieval

Latvia - Wikipedia, The Free Encyclopedia
Both countries are home to a large number of ethnic Russians (26.9% in Latvia and as it dispossessed peasants of their land without compensation, forcing them to return to work at the estates "of their own free will skilled workers were transferred into the republic from all over ... Read Article

Medical Member Claim Form - Benefits Online
Anthem Blue Cross Plan by the provider of service (the physician, Have you filed for Workers’ Compensation For your convenience the Customer Service number is listed on your ... Read More

Department Of Human Resource Management Workers ...
If the employee is insured by Anthem, Interested injured workers enroll by phone. Once enrolled, First Script contacts the injured worker’s doctor and Workers' Compensation Act, shall immediately provide the employee ... View Doc

Subrogation Form 12-01 - BlueCross BlueShield Of South Carolina
Group Number: Address and Phone #: your workers’ compensation claim, we consider the settlement payment to be covered by workers’ compensation and we will not provide medical benefits for the injury or illness. ... View Document

Medical Claim Form - Pearson Benefits Website Home Page
Home phone no. Work phone no. Date of birth (MM/DD/YYYY) Section 3 Have you filed for Workers’ Compensation? If you have questions or need any assistance, please call the number listed on your Member ID card. ... Read More

Midwest Provider Par Form 2005 - Hearing Center Inc.
Anthem Provider Number: Provider’s Anthem assigned personal identification number. If Workers Compensation or Subrogation is involved. Please include accident date. Provider Name Phone No. ... Get Content Here

Participating Workers Compensation Provider Directory For ...
Participating Workers Compensation Provider Directory for State of Arizona your insurance identification card for the phone number for benefits or claims assistance. ANTHEM LABORATORY CORPORATION OF AMERICA 3654 W Anthem Way Anthem, AZ 85086 ... Read Here