Claims Submissions and Disputes
You have the right to request an appeal of a coverage decisions. You may request this appeal on your own behalf or on behalf of a covered Individual.
Anthem Blue Cross and Blue Shield Medicaid uses Availity, a secure, full-service web portal that offers a claims clearinghouse and real-time transactions at no charge to healthcare professionals. Use Availity to submit claims, check the status of all your 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 resources
For a complete guide to claims and the claim payment appeal process for providers, please refer to the provider manual.
- Anthem Blue Cross and Blue Shield Medicaid Provider Grievance Form
- Member Value-Added Benefit: Free Sports Physicals
- Claim Correspondence Form
- Vaccines for Children Program billing guidelines
- Update Taxonomy Code
- Update to Sanctioned Provider Edit
- Coordination of benefits — policy update
- E59 denials — attending taxonomy missing/invalid
- Physician Fee Schedule - POS Mapping
- New place of service code for telehealth
- Facility clinic charge reimbursement policy
- IMPORTANT Claims Edits for ORPA Providers
- Facility Clinic Charge Bulletin
- CMS-1500 Form & UB04 Taxonomy Code Requirements
- Fee Schedule Reimbursement
- PCP Rate Increase Decommissioning Update
- Reimbursement for Professional Vision Services
- ICD-10 Coding Update
- CMS, AMA help providers prepare for ICD-10 transition
- Update: Dental Screening Code D0109
- Submitting corrected claims electronically
- Lesser of Application
- Update to Attending Provider Billing Requests
- Reduction in reimbursement to nonparticipating providers
- Sanctioned Provider Edits
- Provider Appeals - Medical Necessity and Payment
- Claim denial — Z21 provider type
- Alliant Health Solutions Partnership
- Federally qualified health center and rural health center claims encounters
- DRG Outlier Claims Updated
- Frequently asked questions on Ordering, Referring, Prescribing and Attending edits
- Notice to EMS Providers
- Multiple Radiology Payment Reduction
- Claims billed with modifiers GR, GY, GX and GZ
- Participating hospitals: nonpriced codes effective April 15, 2018
- Billing Guidelines for Transgender Members
- Changes to prior authorization
- Multiple Radiology Payment Reduction Reimbursement Policy Update
- Listing of high-tech radiology procedure codes
- 340B Reconciliation of Claims
Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield Medicaid.