Action required: 2022-member grievance and appeals attestation requirement
Anthem Blue Cross (Anthem) participating providers are required to acknowledge (annually) that member grievance and appeals forms, a description of grievance procedures, and assistance in ﬁling grievances are readily available at each contracted provider location.
To complete this year’s required attestation, due by July 17, 2022, please follow the steps below. The process takes approximately five minutes.
- Select the survey questionnaire and attestation.
- Answer the questions and provide the information
- Complete the attestation and submit.
All pertinent information related to this requirement, including access to forms (in multiple languages) and procedures, is located at anthem.com/ca/forms.
- Go to View by Topic and select the drop-down menu.
- Select Grievance & Appeals.
- Select the desired resource link.
We appreciate your cooperation and support. For additional information regarding member grievance and appeals requirements, please see below.
The Department of Managed Health Care’s (DMHC) routine medical survey includes evaluation of a health plan’s compliance with California Health and Safety Code section 1368(a)(2); 28 CCR 1300.68(b)(6) and (7). These regulations require health plans to ensure that grievance forms, a description of grievance procedures, and assistance in ﬁling grievances are readily available at each contracting provider’s office, contracting facility, or plan facility.
Please review and distribute the Anthem grievance form to all your participating offices. It is important to implement processes to provide grievance forms and assistance to Anthem members promptly upon request.
Your agreement with Anthem requires you to comply with all applicable laws and regulations and to cooperate with Anthem’s administration of its grievance program which includes annually attesting that member grievance and appeals forms, a description of grievance procedures, and assistance in ﬁling grievances are readily available at each contracting provider’s office, contracting facility, or plan facility.
Information can be accessed on the process of submitting member grievances and appeals, grievance forms in multiple languages, and deﬁnitions and appeal rights at anthem.com/ca/forms and within the Anthem Blue Cross Provider Manual.
July 2022 Anthem Blue Cross Provider News - California