Anthem Form 151 is a standardized document used by healthcare providers and billing offices to report claim discrepancies directly to Anthem Blue Cross and Blue Shield. The form collects the provider's name, address, and National Provider Identifier (NPI), along with the insured member's Anthem identification number and the original claim number. Providers specify whether the claim involves professional services, facility charges, or dental work, and whether the original submission was on paper or electronic.
Three types of claim situations call for this form. Providers use it to report overpayments they need to return to Anthem, to dispute underpayments where reimbursement was lower than contracted rates, or to correct general billing errors that emerged after initial processing. Because each category routes to a different mailing address within Anthem's network, providers must confirm the correct destination before submitting. For Federal Employee Program (FEP) claims, Anthem routes adjustments through a dedicated channel with its own address listed on the form.
To support accurate processing, the form prompts for the original claim number, the date of service, the amount billed, and the amount Anthem paid. Including all of this in the correct fields helps Anthem's team resolve the adjustment without requesting additional documentation. Providers in Virginia and other states where Anthem operates under regional trade names should confirm which office handles their specific plan. If you need related insurance documents, see the Anthem Blue Cross Application Form, the Adjustment Request Form, or the United Healthcare Claim Form for other carriers. For other Anthem-specific forms, see the Anthem W-9 and the Empire Blue Cross Claim Form.
| Question | Answer |
|---|---|
| Form Name | Anthem Form 151 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | anthem 151, 151 bcbs, anthem 151 fillable, anthem form 151 adjustment request |
