Claims Submissions and Disputes

If a provider does not agree with the outcome of a claim determination, the provider may appeal the decision by using the claim payment appeals process. If there is a full or partial claim rejection or the payment is not the amount expected, submit a claims appeal. The appeal must be received by Anthem Blue Cross (Anthem) within 365 days from the date on the notice of the letter advising of the action.

Anthem uses Availity, a secure, full-service web portal that offers a claims clearinghouse and real-time transactions at no charge to health care professionals. Use Availity to submit claims, check the status of claims, appeal a claim decision and much more .

Don’t have an Availity account?

Finding claims tools on Availity

Submit claims

From the Availity home page, choose Claims & Payments from the top navigation.
Select Type of claim from the drop-down menu.

Claims status inquiry

From the Availity home page, select Claims & Payments from the top navigation.
Select Claim Status Inquiry from the drop-down menu.

Claims dispute

To check claims status or dispute a claim:

From the Availity home page, select Claims & Payments from the top navigation.
Select Claim Status Inquiry from the drop-down menu.
Submit an inquiry and review the Claims Status Detail page.
If the claim is denied or final, there will be an option to dispute the claim. Select Dispute the Claim to begin the process. You’ll be redirected to the payer site to complete the submission.

Clear Claims Connection

To use Clear Claims Connection:

From the Availity home page, select Payer Spaces from the top navigation.
Select the health plan.
From the Payer Spaces home page, select the Applications tab.
Select the Clear Claims Connection tile.

Related information

Billing, claims & appeals forms

Provider tools & resources

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