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Anthem Prior Authorization via Availity Essentials

Anthem Blue Cross and Blue Shield, part of Elevance Health, takes commercial prior authorization requests for medical and behavioral health services, inpatient and outpatient, through the Authorization application in Availity Essentials. There is no national paper form. A clinician or office meets it whenever a service on the member's state prior authorization list is ordered, entering the request online and attaching clinical records.

Who completes it

The ordering or rendering provider, or office staff, enters the online request and attaches supporting clinical documentation.

Submitting and payment

How to submit it
Open the Authorization application from the Patient Registration tab in Availity Essentials; use a state-specific form only where Anthem's state forms library or state law requires one.

Good to know

  • Anthem publishes separate prior authorization lists by state, including California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, Ohio, Virginia and Wisconsin.
  • Anthem's forms libraries are state-specific, and its Medicaid plans post their own state precertification request forms.
  • Where a state requires its own uniform prior authorization form, Anthem posts it in that state's forms library for use instead of the online request.
  • Anthem's medical policies and clinical utilization management guidelines help determine whether a requested procedure is medically necessary, so review the relevant policy before submitting.

Get the official form

Download the current version from the source each time; forms change without notice.

Anthem (Elevance Health) prior authorization request via Availity

Official page

Get the note ready with Vero

Anthem Blue Cross and Blue Shield (Elevance Health) takes this form through its online services or your EMR, so there is no PDF to fill. Vero Scribe writes the visit note it draws on, so the details are ready when you complete it.

See how Vero Scribe works

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.

Frequently asked questions

Does Anthem have a prior authorization fax form?

Anthem has no national paper prior authorization form for commercial members. Requests go through the Authorization application in Availity Essentials. Some states have Anthem state-specific forms or state-mandated uniform forms, which are posted in that state's Anthem forms library.

How do I know if an Anthem service needs prior authorization?

Check the State Prior Authorization List for the member's state on Anthem's provider prior authorization page. The lists identify the member services that require approval and differ by state, so a service that needs authorization in one Anthem state may not in another.