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.
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Referencing outdated clinical criteria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.