Anthem Colorado Mental Health Billing: 5 Easy Essentials
Anthem Colorado mental health billing is the process of getting behavioral health claims paid by Anthem Blue Cross and Blue Shield in Colorado. Elevance Health, Anthem’s parent company, says in its 2025 annual report that it is the Blue Cross and Blue Shield licensee for Colorado. Carelon Behavioral Health also appears on the provider side, so know which company does what.
Anthem Colorado mental health billing: what the guides say
Carelon’s Colorado quick reference guide (updated February 7, 2023) is written for providers working with Anthem Blue Cross and Blue Shield and HMO Colorado, Inc. It lists contacts for claims, prior authorization, eligibility and credentialing. It tells providers to use Availity, the portal for eligibility and claims, and to call the number on the member’s ID card for prior authorization. It does not state a payer ID or a filing limit, so get those from your contract.
Carelon’s Colorado resources page adds a provider handbook addendum, a guide titled “How to Correct Common Claim Denials”, and links to Anthem’s own behavioral health, claim submission and forms pages. Bookmark it, and download the files you use so you have a dated copy.
| Task | Where to look |
|---|---|
| Eligibility and claims | Availity |
| Prior authorization | Number on the member ID card |
| Credentialing contacts | Carelon Colorado quick reference guide |
| Fixing common denials | Carelon’s denial-correction guide for Colorado |
| Plan details we track | Our Colorado Blue Cross guide |
How do I bill Anthem for mental health in Colorado?
Check eligibility in Availity, record who manages mental health benefits, and submit the claim as the check directs. Keep the authorization number with the chart. Anthem Colorado mental health billing is easiest when the front desk writes down the vendor and the date of every check.
Private payers
Your Anthem contract sets your rate, your filing window and your appeal deadline. Pull it and make a one-page summary for staff. Psychotherapists bill time-based visits. Psychiatrists bill evaluation and management (E/M) visits, often with a psychotherapy add-on code, so ask whether Anthem routes those visits to the same place. If you are out of network, the rules differ, and our guide to in-network and out-of-network credentialing shows how.
Medicare and Medicaid
The Carelon guide above covers Anthem’s Blue Cross and Blue Shield plans and does not describe Medicare Advantage or Medicaid billing for Colorado. Medicare and Medicaid have separate rules, so check CMS and the state Medicaid agency before you apply anything on this page to those programs.
State rules
Colorado’s prompt-pay law, C.R.S. 10-16-106.5 (2025 version on Justia), sets payment deadlines for carriers. A clean claim must be paid within 30 calendar days when sent electronically, and within 45 days when sent another way. If the carrier needs more information, it must say so in writing within 30 days. Late clean claims owe 10% annual interest, and claims unresolved after 90 days face a 20% penalty on day 91. The statute may not reach every plan, such as self-funded employer plans, so ask your counsel before you rely on it.
Anthem also holds licenses in California and Nevada. Those states are not covered here, and Colorado rules should never be applied there.
Denials and Anthem Colorado mental health billing problems
Most denials start with a front-desk gap: the wrong payer, no recorded authorization, or an old credentialing record. Read the remittance codes (see our guide to CARC and RARC codes), match them to your contract, and use Carelon’s Colorado denial guide for common fixes. Track your clean claim rate so you can see whether the front-desk changes work.
Keep a simple log
A one-page log makes Anthem Colorado mental health billing easier to audit. For each patient, record the plan name, the date you checked eligibility, who manages mental health, the authorization number, and where the claim went. Add the date of each call and the representative’s name. When a claim is denied, you can answer in minutes instead of hours.
Review the log monthly. If the same step fails twice, change the front-desk habit, not just the claim. That is the cheapest fix in Anthem Colorado mental health billing, and it protects your cash flow.
What to do Monday morning
- Pull your Anthem Colorado contract and mark the filing and appeal windows.
- Run an eligibility check for each Anthem patient and note the mental health administrator.
- Download Carelon’s Colorado guides and save them with the date.
- Check that your credentialing record matches your tax ID and address.
- Find the right department in our insurance companies contact directory before you call.
The short version: Anthem Colorado mental health billing
Anthem Colorado mental health billing depends on three things: the right payer, a current credentialing record and a known filing window. Use Availity for eligibility and claims, keep dated copies of Carelon’s guides, and read Colorado’s prompt-pay law with your counsel.
How MCM South helps
MCM South Medical Billing Service, LLC bills exclusively for mental and behavioral health. We work with psychotherapists and psychiatrists in solo and medium-size practices, including in Colorado, and we bill out-of-network claims for clients. For payer follow-up, see our service for denied and rejected claims.
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Related reading
Want help with payer follow-up? Talk to us.
FAQ
Is Anthem Colorado the same as other Blue Cross plans?
No. Anthem is the Blue Cross and Blue Shield licensee for Colorado, and other Blue plans are independent. Do not apply Anthem rules to another Blue plan.
How fast must Colorado carriers pay a clean claim?
Under C.R.S. 10-16-106.5, a clean claim sent electronically is due within 30 calendar days, and within 45 days when sent another way. Late payments owe interest. Confirm that the law applies to your plan.
Where do I send Anthem Colorado claims?
Carelon’s Colorado guide tells providers to use Availity. Your eligibility check shows if a vendor handles mental health and how it wants claims sent.
Does this post cover Anthem in California or Nevada?
No. Elevance holds licenses there too, but those states have their own rules. Check the plan and state before you bill.
Where MCM South works
MCM South Medical Billing Service, LLC works with psychotherapists and psychiatrists in our ten currently served states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois. We serve solo and medium-size practices that bill mental and behavioral health. Founder Michael Williams has worked with insurance payers in all 50 states. Browse the state and regional billing guides for rules that vary by state, or see our billing services.
This post is operational guidance for billing, not legal advice. Rules change, so confirm with the payer or your counsel.
