If your provider does not submit to Anthem on your behalf, you will have to complete this Medical/Vision claim form and file directly to Anthem. This includes claims you have already paid in advance.
- This form must be completed by you.
- Attach an itemized bill (See Anthem's form on what is an acceptable itemized bill).
- You must send this claim to the Local Blue Cross/Blue Shield address for the state you live in.
- Please keep a copy for your records and the date that it was sent to Anthem.