How to appeal an Elevance Health denial

To appeal an Elevance Health denial, file an internal appeal within 180 days of the date on the denial letter; Elevance Health returns standard decisions in 30 days, and if it upholds the denial you can request an independent external review within 4 months. Pick your treatment below for a step-by-step guide.

Appeal guides by treatment

Each guide covers the Elevance Health-specific filing window, decision timeline, common denial reasons, and how to submit your appeal.

• Elevance Health glp-1 weight-loss drugs denial →
• Elevance Health mental health & behavioral health denial →
• Elevance Health fertility & ivf denial →
• Elevance Health adult adhd medications denial →
• Elevance Health specialty biologics denial →
• Elevance Health cancer treatments denial →
• Elevance Health ms treatments denial →
• Elevance Health surgery denied as 'not medically necessary' denial →
• Elevance Health out-of-network emergency denial →
• Elevance Health migraine cgrp inhibitors denial →
• Elevance Health pediatric therapy denial →
• Elevance Health continuous glucose monitors & insulin pumps denial →
• Elevance Health genetic testing denial →
• Elevance Health hepatitis c cures denial →
• Elevance Health sleep medicine — cpap, bipap, asv, oral appliances, inspire hns denial →
• Elevance Health dme — wheelchairs, prosthetics, orthotics denial →
• Elevance Health dental — medical necessity, oral surgery, tmj, cleft palate denial →
• Elevance Health interventional pain — scs, rfa, esi, kyphoplasty denial →
• Elevance Health substance use disorder treatment (sud/moud) denial →
• Elevance Health rare disease — ert, substrate reduction, gene therapy denial →
• Elevance Health hiv prep & hiv treatment denial →
• Elevance Health hearing aids, cochlear implants, baha denial →
• Elevance Health hemophilia & bleeding disorders denial →
• Elevance Health cystic fibrosis & pulmonary fibrosis denial →
• Elevance Health cardiology drugs denial →
• Elevance Health cardiac devices & procedures denial →
• Elevance Health neurology — alzheimer's, parkinson's, als, epilepsy denial →
• Elevance Health sickle cell & thalassemia denial →
• Elevance Health vision & retinal — anti-vegf, ga, gene therapy denial →
• Elevance Health kidney disease — ckd, esrd, igan, adpkd denial →
• Elevance Health endocrine (non-diabetes) denial →
• Elevance Health liver (non-hcv) — nash/mash, pbc, aih, wilson denial →
• Elevance Health women's health — menopause, endometriosis, pcos, ppd denial →
• Elevance Health copd severe + alpha-1 antitrypsin deficiency denial →
• Elevance Health diabetes drugs & insulin denial →
• Elevance Health asthma & severe allergies denial →
• Elevance Health orthopedics & sports medicine denial →
• Elevance Health gerd & severe reflux denial →
• Elevance Health ibs & functional gi denial →
• Elevance Health eating disorders — residential / php / iop denial →
• Elevance Health osteoporosis denial →
• Elevance Health long covid / pasc denial →
• Elevance Health severe acne denial →
• Elevance Health eosinophilic esophagitis (eoe) denial →
• Elevance Health iv iron infusion denial →
• Elevance Health hereditary angioedema (hae) denial →
• Elevance Health compounded glp-1 denial →
• Elevance Health pediatric oncology denial →
• Elevance Health maternity & postpartum denial →
• Elevance Health stroke & neuro rehab denial →
• Elevance Health lupus & rheumatology denial →
• Elevance Health chronic wound care denial →
• Elevance Health immune globulin (ivig/scig) for pidd denial →
• Elevance Health adult car-t cell therapy denial →
• Elevance Health myasthenia gravis & cidp denial →
• Elevance Health pulmonary hypertension denial →
• Elevance Health amyloidosis (cardiac attr + al) denial →
• Elevance Health spinal muscular atrophy denial →
• Elevance Health autoimmune cytopenias (itp + aiha) denial →
• Elevance Health c. difficile infection denial →
• Elevance Health solid-organ transplant denial →
• Elevance Health men's sexual health — trt + ed denial →
• Elevance Health treatment-resistant depression — rtms, spravato, ect denial →
• Elevance Health inflammatory bowel disease (crohn's + uc) denial →
• Elevance Health plaque psoriasis + psoriatic arthritis denial →
• Elevance Health atopic dermatitis (ad / eczema) denial →
• Elevance Health glaucoma (drops + procedures + surgery) denial →
• Elevance Health multiple myeloma (non-car-t) denial →
• Elevance Health prostate cancer denial →
• Elevance Health melanoma & melanoma-immunotherapy denial →
• Elevance Health pediatric epilepsy denial →
• Elevance Health growth hormone replacement therapy denial →
• Elevance Health bph procedures + medical therapy denial →
• Elevance Health lymphoma & leukemia (heme malignancies) denial →
• Elevance Health bone marrow transplant (allogeneic hsct) denial →
• Elevance Health neurosurgery — discectomy, laminectomy, craniotomy, shunt denial →
• Elevance Health radiation oncology — proton, sbrt, brachytherapy, imrt, iort denial →
• Elevance Health thyroid eye disease (ted) — tepezza (teprotumumab) and igf-1r therapy denial →
• Elevance Health compounded medications (non-glp-1) — bhrt, ldn, ketamine, custom-dose pediatrics denial →
• Elevance Health ent / otolaryngology — sinus surgery, septoplasty, tonsillectomy, head & neck denial →
• Elevance Health vascular & endovascular — aaa, carotid, pad, varicose veins, ivc filters denial →
• Elevance Health bariatric surgery — rygb, sleeve, duodenal switch, sadi-s, revision, esg denial →
• Elevance Health interventional radiology — ufe, pae, tips, y-90, tumor ablation, kyphoplasty denial →
• Elevance Health neuropsychological & psychological testing — adhd, tbi, dementia, asd, presurgical eval denial →
• Elevance Health mohs surgery & dermatologic surgery — bcc, scc, melanoma in situ, slnb, pdt denial →
• Elevance Health pediatric subspecialty — cardiology, gi, pulmonology, rheumatology, endocrinology, neurology denial →
• Elevance Health reconstructive plastic surgery — lymphedema, panniculectomy, burn, mohs, hand denial →
• Elevance Health inpatient rehab — irf / snf / ltac admission and length-of-stay denial →
• Elevance Health hospice / palliative — eligibility, gip, recertification, concurrent care denial →
• Elevance Health home healthcare — home nursing, home infusion, home pt/ot/slp, home aide, hospital-at-home denial →