How to Submit a Superbill to Anthem for Therapy Reimbursement

Anthem Out-of-Network Process

Anthem members submit OON claims via the Sydney Health app or the Anthem member portal at anthem.com. After logging in, members navigate to "Claims" and select "Submit a Claim," then attach the superbill PDF. Anthem also accepts mailed paper claims with a completed member claim form. Reimbursements are issued as checks mailed to the member's address on file.

Common Denial Reasons

• ✗Missing group number or member ID on the submitted claim form
• ✗Therapist's professional license type is not covered under the plan
• ✗Claim filed after the 180-day timely filing limit
• ✗Session duration does not align with the CPT code billed (e.g., billing 90837 for a 30-minute session)

Tips for Getting Reimbursed by Anthem

• ✓Anthem's behavioral health is often administered by Beacon Health Options — verify the claims address on the card
• ✓The Sydney Health app makes it easy for clients to photograph and submit superbills directly from their phone
• ✓Ensure your superbill clearly lists session start and stop times, especially for time-based CPT codes
• ✓Anthem often requires a primary care physician referral under certain HMO plans — clients should verify