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Imaging Denial

Anthem / Elevance Denied Your CT Scan?

According to federal data, Anthem Blue Cross Blue Shield (Elevance Health) denies approximately 15.3% of claims. When patients appeal, about 54% are overturned. Your ct scan denial may have grounds for a successful appeal.Sources: KFF ACA Marketplace Transparency Data, HHS OIG Reports, state insurance department filings. Rates are aggregate averages — individual results vary by plan type, denial reason, and documentation.

15.3%
Denial Rate
54%
Appeal Success
30-60 days
Typical Timeline
$1,000–$5,000
Typical Claim

Based on published government and industry research. Individual results vary based on denial type, insurer, and documentation.

Why Anthem / Elevance Denies CT Scan

Not medically necessary based on clinical criteria

MRI recommended instead of CT

Prior imaging not attempted first

Anthem / Elevance's Common Denial Tactics

Referencing outdated clinical criteria

Bundling denials across multiple related claims

Claiming services are "not medically necessary" without specific reasoning

How to Win Your CT Scan Appeal

Physician order with clinical indication

Evidence that CT is more appropriate than MRI for the condition

ACR Appropriateness Criteria supporting CT for diagnosis

Laws That Protect You

ACA — Preventive screening requirements

State imaging parity laws

Emergency prudent layperson standard

Tips for Appealing to Anthem / Elevance

Demand the specific clinical policy bulletin used for the denial

Check if your state mandates coverage for the denied service

File an external review — Anthem has a 54% overturn rate on appeal

Ready to Review Your CT Scan Denial?

Upload your denial letter and get a clear analysis in minutes. We'll identify potential weaknesses in Anthem / Elevance's reasoning and outline your appeal options.

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This information is for educational and informational purposes only. It does not constitute legal or medical advice. Statistics cited are from publicly available sources including KFF, HHS OIG, and state insurance department data. Individual results may vary. Consult a qualified professional before taking action on your specific situation.

Anthem / Elevance Denied Your CT Scan? Here's How to Appeal | Lysco