Anthem Blue Cross
Anthem Blue Cross of California (Blue Cross of California) · Elevance Health, Inc. · NAIC 70670
Where to send the appeal
Verified addresses and inbound channels. We refresh on every release.
Response timeline
The clocks that matter. Miss them and you escalate to the state insurance commissioner.
Codes worth fighting
Based on outcome data across our payer corpus.
- CO-97
- CO-18
- CO-4
- CO-167
- CO-204
- PR-2
- CO-29
- CO-50
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 ServiceAnthem aggressively denies modifier 59 on same-day therapy bundling under CO-97. Requires explicit medical-necessity documentation that services were distinct.
Modifier 25
Significant, Separately Identifiable E/M ServiceModifier 25 frequently denied on same-day visits with procedure code. Anthem applies stricter documentation standard than CMS baseline.
Modifier GP
Services delivered under outpatient PT plan of careRequired for PT services; missing modifier triggers automatic denial. Often re-applied successfully on appeal with proof of plan of care.
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.
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