Anthem sent you a surprise bill? Here’s what to do
Summary: Under the federal No Surprises Act, you usually cannot be balance-billed for emergency or out-of-network care at an in-network facility — dispute the bill before paying.
Why Anthem sent you a surprise bill
- Out-of-network providers worked at an in-network facility (ER, anesthesiology, radiology).
- An emergency where you had no choice of provider.
- A billing or coding error inflated the patient-responsibility amount.
Step by step: what to do
- Do not pay yet — request a fully itemized bill from the provider.
- Call Anthem at 1-833-848-8729 to confirm how the claim was processed and the in-network rate.
- Cite the No Surprises Act if you were balance-billed for protected care.
- File a written dispute through the appeal address on your denial letter or the Anthem member portal and ask for the bill to be reprocessed.
- Escalate to your state Department of Insurance (and the federal No Surprises Act) if the surprise bill is not corrected.
Common mistakes to avoid
- Paying a surprise bill before disputing it.
- Not getting an itemized bill to spot duplicate or upcoded charges.
- Missing the 180 days from the date of the denial window to dispute.
What to say when you call Anthem
- I received a surprise out-of-network bill and I believe it’s protected under the No Surprises Act.
- Please reprocess the claim at the in-network rate and send me the corrected explanation of benefits.
Know your rights
You have the right to a written explanation of any denial, to a full copy of your plan documents, and to appeal — first internally, then through an independent external review.
Regulator: your state Department of Insurance (and the federal No Surprises Act). If the internal appeal fails, request an external review and file a complaint with your state Department of Insurance.
Don’t sit through Anthem’s phone menu
Karen calls Anthem at 1-833-848-8729, works through the phone tree, and waits on hold for you. Once she reaches a human representative, she adds you to the call.
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Frequently asked questions
What is the No Surprises Act?
A federal law that protects you from most surprise out-of-network bills for emergency care and for care from out-of-network providers at in-network facilities.