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Payer playbook · CA

Anthem Blue Cross

Anthem Blue Cross of California (Blue Cross of California) · Elevance Health, Inc. · NAIC 70670

01

Where to send the appeal

Verified addresses and inbound channels. We refresh on every release.

Fax
+1-866-518-1305
Mailing address
Anthem Blue Cross — Provider Appeals P.O. Box 60007 Los Angeles, CA 90060-0007
02

Response timeline

The clocks that matter. Miss them and you escalate to the state insurance commissioner.

First-level response
30 days
Second-level response
30 days
Provider appeal window
365 days
State prompt-payment window
30 days
Expedited pathway
72 hours
03

Codes worth fighting

Based on outcome data across our payer corpus.

Known win codes
  • CO-97
  • CO-18
  • CO-4
  • CO-167
  • CO-204
  • PR-2
Known difficult codes
  • CO-29
  • CO-50
04

Modifier behavior

The denials this payer applies on modifier-bearing claims. The rebuttal language is part of the Denial OS letter generator and not published here.

Modifier 59

Distinct Procedural Service

Anthem aggressively denies modifier 59 on same-day therapy bundling under CO-97. Requires explicit medical-necessity documentation that services were distinct.

Recommended rebuttal language is part of the Denial OS letter engine — start a free appeal to see it in context.

Modifier 25

Significant, Separately Identifiable E/M Service

Modifier 25 frequently denied on same-day visits with procedure code. Anthem applies stricter documentation standard than CMS baseline.

Recommended rebuttal language is part of the Denial OS letter engine — start a free appeal to see it in context.

Modifier GP

Services delivered under outpatient PT plan of care

Required for PT services; missing modifier triggers automatic denial. Often re-applied successfully on appeal with proof of plan of care.

Recommended rebuttal language is part of the Denial OS letter engine — start a free appeal to see it in context.
05

Interest statute

The legal basis for charging interest when payment runs late.

California Insurance Code §10123.13 (prompt-payment, 10% interest after 30 days for clean claims)

You have the playbook. Now write the letter.

Paste your EOB and Denial OS generates the appeal in five minutes — citing the contracted rate, the modifier rebuttal, and the deadline statute that matches this exact payer.

Start your appeal