Required Information
When you request payment of benefits from Anthem Blue Cross, you must provide Anthem Blue Cross with all of the following information.
  • The member's name and address.
  • The patient's name, age, and relationship to the member.
  • The member identification number and group number stated on your ID card.
  • An itemized bill from your provider that includes the following:
    • Patient diagnosis;
    • Date(s) of service;
    • Procedure code(s) and description of service(s) rendered;
    • Charge for each service tendered; and
    • Provider name, address, and Tax Identification Number (TIN).
  • The date on which the injury or sickness began.
  • A statement indicating whether or not you are enrolled for coverage under any other health insurance plan or program. If you are enrolled for other coverage, you must include the name(s) of the other carrier(s).
Send your claim to:
Anthem Blue Cross
P.O. Box 60007
Los Angeles, CA 90060-0007