Resources & Forms

Resources

Resources to help you better understand and use your health plan and Anthem's online tools.

. Opens in new window Guided Tour Video: LiveHealth Online
. Opens in new window How to Check Claim Status
. Opens in new window Your Protection Against Surprise Medical Bills
. Opens in new window Site of Care Program for Infusions Drug List

Forms

View and download commonly used forms.

. Opens in new window Medical Claim Form
. Opens in new window Member Release of Information Authorization Form
. Opens in new window International Claim Form
. Opens in new window Designation of Representative Form
. Opens in new window Surprise Medical Bill Assignment of Benefits Form

How to File a Grievance or Appeal

If you would prefer to send a written complaint you can mail or fax it using the information below. Please include your preferred contact information so that we can reach out to you with additional questions if needed.

Mail it

Grievances and Appeals

PO Box 1407

Church Street Station

New York, NY 10008-1407

 

 

Call us

877-7-NYSHIP (877-769-7447)

Press or say "Option 2" for information or to initiate an appeal. Representatives are available M–F, 8 a.m. to 5 p.m. Eastern Time.

TTY: 800-241-6894

Appeals

If you'd like an update on your issue or information on the aggregate number of grievances, appeals, and exceptions filed, please call 877-7-NYSHIP (877-769-7447) and press or say "Option 2" for the Hospital Program.