About Anthem / Elevance Health
Elevance Health, formerly known as Anthem, is the second largest health insurer in the United States with 12% commercial market share. The company operates Blue Cross Blue Shield-branded plans across 14 states including California, New York, Georgia, Ohio, Indiana, Virginia, and Missouri. Elevance serves over 40 million members across commercial, Medicare, and Medicaid lines.
How fast does Anthem / Elevance Health pay?
Anthem and Elevance Health plans typically reimburse clean claims within 30 to 45 days. Surgical and procedural claims requiring clinical review can extend to 60 days. Behavioral health claims are subject to additional medical necessity review and may take 45 to 90 days.
Common denial and billing issues.
- Prior authorization not obtained or expired at time of service
- Claim submitted to wrong Anthem entity (commercial vs. Medicaid)
- Medical necessity denials on inpatient and observation stays
- Modifier requirements not met for bilateral procedures
- Coordination of benefits pending delays
- Facility vs. professional billing overlap denials
Prior authorization requirements.
Anthem requires prior authorization for inpatient admissions, select outpatient surgical procedures, specialty medications, home health, and behavioral health beyond initial visit limits. Authorization is managed through Anthem's provider portal or CareCore/AIM Specialty Health for imaging and specialty procedures.
How Copay works with Anthem / Elevance Health.
Anthem and Elevance plans are among the most frequently purchased claims in Copay's network. Reimbursement data across Anthem's 14-state BCBS footprint is incorporated into Copay's ENR model, giving your purchased claims accurate valuation specific to your Anthem contract tier and state.
Stop waiting on Anthem / Elevance Health.
Eligible claims are purchased and funded the next business day.