Anthem Blue Cross Blue Shield (now Elevance Health) is one of the largest health insurers in the U.S. This guide covers their specific appeal process, timelines, and strategies for successful reversals.
Anthem Appeal Process
Internal Appeal
- File within 180 days of denial notice
- Submit via mail, fax, or the Anthem member portal (anthem.com)
- Include all supporting medical records
- Anthem must decide within 30 days (pre-service) or 60 days (post-service)
- Urgent appeals: 72 hours
External Review
- Available after exhausting internal appeals
- File through your state insurance department
- Anthem is required to comply with the external reviewer's decision
Anthem-Specific Tips
- Use Anthem's Clinical UM Guidelines — available on the provider site — to frame your appeal
- Anthem's prior auth portal (availity.com) can provide real-time status
- Request the specific guideline used for denial — Anthem must share it
- Cite peer-reviewed literature that supports medical necessity
- If Anthem BCBS: Appeal rights may vary by state BCBS plan
Key Contact Information| Department | Contact |
|---|
| Member Services | Number on your ID card |
| Appeals | Address on denial letter |