Don’t Wait to Submit Your Non-Network Claims to Anthem

Published July 9, 2021

Get instant confirmation when you submit non-network claims online at www.anthem.com.

Despite the time and financial savings you get from using Anthem Blue Cross network providers, there are circumstances in which you may choose to use services or providers outside the network. If you incur a non-network medical claim, you will likely have to submit the claim yourself. To help ensure your claim gets processed timely, be sure to follow the three simple steps below.

(1) Submit claims online at www.anthem.com…NOT myPHP.

The easiest and quickest method to submit your non-network claims is online at www.anthem.com. Registered users of the Anthem online portal can login, click Claim & Payments and choose Submit a Claim to begin the process. To complete your claim submission, you will supply a few key pieces of information, upload your documents and click Submit. You will receive instant confirmation that your claim has been submitted. Visit www.dgaplans.org/filing-a-claim for more detailed instructions for filing your claims at www.anthem.com.

Once the Plans office has processed the claim, detailed claims information and a downloadable Explanation of Benefits (EOB) will be available on the myPHP online benefits portal at www.dgaplans.org/myPHP. You must be a registered user to access your claims information.

PLEASE NOTE: Though myPHP provides many important online services, claims submissions must go through Anthem. Submitting claims through myPHP will severely delay processing.

(2) Submit claims timely.

You have one year from the date of service to file a claim. Any claims received after this deadline will be denied. Timely filing is even more important if the Health Plan is your secondary insurer. The Health Plan will not pay claims until your primary insurance has paid their portion of the claim. Once your primary insurance pays, you can submit your claim and the EOB from your primary insurance to Anthem. The longer your primary insurance takes to pay, the less time you have to submit your claim to the Anthem, and the more likely you are to exceed the timely filing deadline. Submitting claims as soon as possible after the date of service ensures timely processing and can prevent unanticipated out-of-pocket costs.

(3) Don’t let claims accumulate.

The Health Plan only pays benefits on claims that are medically necessary and reviews claims for medical necessity on a regular basis. Submitting your claims as they are incurred not only ensures your claims are filed timely, but can also help you avoid billing surprises that may occur if your claims are later determined to not be medically necessary. In those cases, you may be responsible for paying for any denied claims out of pocket. However, if you submit claims as you go, the Health Plan can notify you when a claim is denied for not being medically necessary so that you can decide if you want to continue treatment without the Health Plan’s benefits.