Prior authorization to Anthem Blue Cross Blue Shield

Anthem Blue Cross Blue Shield operates as distinct state-licensed plans across many states. Prior authorization requirements, fax numbers, step therapy rules, and covered services differ significantly between California, Ohio, Georgia, Virginia, and every other state Anthem serves. Always confirm which state entity covers the member before submitting — a request routed to the wrong state plan restarts the review clock and can delay care by days.

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Anthem Blue Cross Blue Shield

CommercialMedicare AdvantageMedicaid

PA Fax: +18773784643
PA Phone: +18005768000
Standard turnaround: 3 business days
Urgent turnaround: 72 hours

PA requirements vary by state plan. Check Anthem provider portal for your specific plan.

Anthem Blue Cross Blue Shield provider portal →

What you'll need

★ PortalFaxPortal preferred

☐Confirm state-specific Anthem plan (requirements differ by state)
☐Ordering provider NPI
☐Patient member ID
☐ICD-10 diagnosis code(s)
☐CPT procedure code(s)
☐Clinical notes and supporting documentation
☐Rendering provider NPI and facility information

▶Common denial reasons

⚠State plan exclusion — requirements vary significantly by state
⚠Incomplete clinical documentation
⚠Out-of-network provider without referral authorization
⚠Step therapy not documented (try conservative treatment first)

Verified 2026-05-20. Check payer site for current rules →

From $2.99 per submission

PA Agent requires an account so you can track submissions, record outcomes (approved/denied), and pre-fill appeals automatically. It's free to join.

You can preview the form below — sign in before generating or submitting.

⬆ Import from CSVDownload template

Submission checklist

○Provider name, NPI, practice name

○Provider phone & fax number

○Patient name, DOB, member ID

○ICD-10, diagnosis, CPT, procedure

○Clinical notes (min 50 chars · 0 entered)

✓Fax destination number

○AI justification generated & reviewed

1 of 7 checks complete

Prior Authorization Request

1. Provider Information

Provider Name *

NPI * (10 digits)

Practice Name *

Provider Phone *

Provider Fax *

2. Patient & Insurance

Patient Name *

Date of Birth * (MM/DD/YYYY)

Member ID *

Group Number

💬 Patient notifications: add the patient's email below and they'll automatically receive an email when you record the insurer's decision on the tracking page — no phone call needed.

Patient Email (for outcome notifications)

Patient Phone (for future SMS notifications)

3. Clinical Details

ICD-10 Code *

Diagnosis Description *

CPT Code * (5 digits)

Procedure Description *

Urgency

4. Clinical Notes

Provider notes & supporting rationale *(min 50 chars)0/10000

5. AI Clinical Justification

PHI notice: Clicking “Generate with AI” sends clinical notes and diagnosis to OpenAI for processing. Do not include information beyond what is clinically necessary. Review your organization's policies before submitting patient data to third-party AI services.

6. Submission Method

✓ Pre-filled with Anthem Blue Cross Blue Shield's PA fax number.