Community denied your claim in Ohio. Here is your deadline.
Put in the date on your Community Insurance Company(Anthem BCBS) notice and get both federal deadlines as calendar dates.
Free, for a Community Insurance Company(Anthem BCBS) denial in Ohio, and it runs entirely in your browser. The date, the plan type and the state you pick are never sent to us and never stored.
Community Insurance Company(Anthem BCBS) denied 294,314 of 3,535,080 in-network claims in Ohio; every one of those denials had these same two dates on it. Across Ohio as a whole the insurers in this file denied 17.9% of in-network claims, 2,934,307 of them, and 35,236 were appealed.
Community Insurance Company(Anthem BCBS) denied 8.3% of in-network claims in Ohio, 294,314 claims out of 3,535,080.
Insurance got denied, what to do next?
Those 294,314 denials are 10% of every in-network denial recorded in Ohio in this release, which makes Community Insurance Company(Anthem BCBS) the 5th largest source of denials of the 10 insurers reporting there. Spread across its 12 plans in the state that is about 24,526 denials per plan. 841 internal appeals were filed against those 294,314 denials. Every one of those denials carried the same two dates the tool at the top of this page works out.
Two dates matter more than anything else on this page, and they run the same in Ohio as everywhere else. You have 180 days from the date on your denial notice to file the internal appeal, and then 4 months from the final internal denial to ask for an independent external review. If waiting would seriously jeopardize your health you can ask for both to be expedited, decided in about 72 hours. Both timeframes are federal, not your insurer's choice, 29 CFR 2560.503-1 (PDF) and 45 CFR 147.136 (PDF), in plain English at HealthCare.gov, and your own denial letter states the ones that govern your plan. The PDFs are the same sections on govinfo.gov, which serves them without a challenge page, so an automated reader can check these two dates as easily as you can.
You are not alone, and here is the measured version of that sentence: 294,314 in-network claims were denied by Community Insurance Company(Anthem BCBS) in Ohio in a single plan year. A denial rate is a fact about an insurer's book of business. It is not a judgment about you, and it is not the last word on your claim.
- Of the 10 insurers reporting a denial rate in Ohio, Community Insurance Company(Anthem BCBS) is the tenth highest at 8.3%. The highest in the state is 26.5% and the lowest is 8.3%.
- That is 10.4 percentage points below the 18.7% national average across this dataset, and 9.6 points below the Ohio average of 17.9%.
- Behind the percentage: 3,535,080 in-network claims were processed under 12 plans in Ohio, and 294,314 of them came back denied.
- For every 10,000 claims Community Insurance Company(Anthem BCBS) denied, about 29 came back as an internal appeal. The other 9,971 stopped at the letter.
- Of the internal appeals it did receive, Community Insurance Company(Anthem BCBS) overturned 26.75%, 225 claims that started life as a no.
- Community Insurance Company(Anthem BCBS) accounts for 10% of every in-network claim denied in Ohio in this file.
- By raw volume it is the 53th largest source of denials among the 158 insurer-state records in the file that report one.
- Read the other way round: 3,240,766 of those 3,535,080 in-network claims were paid, 91.7% of everything Community Insurance Company(Anthem BCBS) processed in Ohio.
- Spread across the 12 plans it reports in Ohio, that is about 24,526 denied claims per plan, on about 294,590 claims processed per plan.
- Against the file as a whole, this one record is 0.3% of the 84,502,749 in-network claim denials reported by every issuer in it.
- Find the reason code on your denial letter. The federal file records no denial-reason breakdown for Community Insurance Company(Anthem BCBS) in Ohio, so this page cannot tell you which of the 9 categories yours will be, your letter can, and it has to. Copy the exact wording and the code off it tonight: that sentence is what your appeal has to answer.
- Ask Community Insurance Company(Anthem BCBS) in Ohio for the clinical criteria they judged you against. Under 29 CFR 2560.503-1 they have to hand you the claim file and the policy they applied, free, on request, and you cannot argue with a checklist you have never read.
- Put both deadlines on your calendar before you go to bed. 180 days from the date on the letter for the internal appeal, 4 months from the final internal denial for external review. The free calculator on this page turns your date into the two calendar dates in about ten seconds. Community Insurance Company(Anthem BCBS) overturned 26.75% of the internal appeals it did receive, 225 claims, so the stage you are about to start is not decorative.
None of those three steps costs anything. Anyone charging you to do them is selling you something you can do yourself in twenty minutes.
How that compares
| Denial rate | Rate | Difference |
|---|---|---|
| Community Insurance Company(Anthem BCBS) | 8.3% | , |
| Ohio average | 17.9% | -9.6 pts |
| National average (this dataset) | 18.7% | -10.4 pts |
Community Insurance Company(Anthem BCBS) sits at or below the national average across this dataset. A denial rate is a property of the insurer's book of business, coding practice, plan design, the population it covers, not evidence about the merits of any one claim, including yours.
What happened to appeals
| Stage | Filed | Overturned |
|---|---|---|
| Internal appeal (to Community Insurance Company(Anthem BCBS)) | 841 | 26.75% |
| External review (independent) | not reported | not reported |
What that record means for your own Community Insurance Company(Anthem BCBS) letter, and by when. Community Insurance Company(Anthem BCBS) overturned 26.75% of the 841 internal appeals its Ohio members filed against 294,314 denials, and the Ohio escalation count for Community Insurance Company(Anthem BCBS) is the figure this page names as absent at the top, so how many of those denials went on to the independent stage is not something this page can tell you, Community Insurance Company(Anthem BCBS)'s own rows in the plan-year 2026 release of the CMS Transparency in Coverage file, read September 5, 2026 (data.healthcare.gov). Whichever way that lands, nobody files the appeal for you, and the filing runs on a clock set by which plan you hold: an employer or Marketplace plan gives you at least 180 days from the denial notice to file the internal appeal (29 CFR 2560.503-1(h)(3)(i), carried onto individual-market coverage by 45 CFR 147.136(b)(3)(i)), while Medicare Advantage gives you 60 calendar days after you receive its notice (42 CFR 422.582(b)) and Medicaid managed care the same 60 calendar days from the date on the notice (42 CFR 438.402(c)(2)(ii)), both stages free, and the three steps above are the whole of what to do tonight, so take the date printed on your Community Insurance Company(Anthem BCBS) notice and file well inside whichever of those windows is yours. The free steps are above; the $29 kit is the same clock with the letters pre-filled for Community Insurance Company(Anthem BCBS) in Ohio. One payment. No subscription. No cut of your claim.
Community Insurance Company(Anthem BCBS) inside Ohio
Your denial did not happen in a national average. It happened in a state market, alongside 10 other insurers reporting into the same federal file, and these are that market's own figures.
- Across the whole of Ohio, the 11 insurers reporting in this file processed 16,409,625 in-network claims and denied 2,934,307 of them, a state denial rate of 17.9%. Community Insurance Company(Anthem BCBS) is one of those 11.
- That puts Ohio 18th of 30 states by denial rate, 0.8 points below the 18.7% national average, before you get to what Community Insurance Company(Anthem BCBS) did inside it.
- Ohio recorded 35,236 internal appeals against those denials: one appeal for every 83 claims the state's insurers refused. Community Insurance Company(Anthem BCBS)'s own ratio is one for every 350.
- Independent external review was reached 954 times in the whole of Ohio, once for every 3,076 denials, against one in 14,369 nationally. How many came from Community Insurance Company(Anthem BCBS)'s denials is not on the record, that is the Ohio figure this page names as absent at the top and sources at the foot.
- Of the Ohio external reviews that were filed, 215 were overturned, 22.5%. That percentage is measured on 954 reviews, which is why the count beside it matters more than the rate does when you are deciding whether to file against Community Insurance Company(Anthem BCBS).
- The reason Ohio's insurers record most often is administrative reason, 951,084 claims, 26.4% of the state's categorized denials.
- The other insurers an Ohio reader could have bought from run from 26.5% (Oscar Buckeye State Insurance Corp.) to 14.2% (Paramount Insurance Company). Community Insurance Company(Anthem BCBS) at 8.3% sits below all of them.
- Put the two together and Community Insurance Company(Anthem BCBS) is responsible for 10% of every in-network claim denied in Ohio in this release, from 21.5% of the claims the state's insurers processed.
- Every Ohio figure in this section is that state's own row in the same federal file Community Insurance Company(Anthem BCBS)'s numbers above come from, CMS Transparency in Coverage Public Use File (PY2026 release, PY2024 claims), data.healthcare.gov — US Government public domain, and the full Ohio page is free at /states/ohio.
Put the date from your notice in and get the two calendar dates, with the days remaining.
Runs entirely in your browser, the date you type is never sent to us and never stored. Open the full calculator →
The three steps at the top of this page are the whole of what you have to do tonight. The longer version, what the internal appeal has to contain, how the independent stage works, and how to ask for expedited handling when waiting would seriously jeopardize your health, is published free here. For what it is worth on this page specifically: Community Insurance Company(Anthem BCBS) overturned 26.75% of the internal appeals it received.
Who appeals what at Anthem (Elevance Health), the insurer's own routing table
Anthem (Elevance Health) publishes a table of which denial scenarios are appealed by you, the member ("customer appeal") and which only your health care provider can appeal. Almost no patient ever sees it, and appealing a denial that only your provider has standing to appeal burns time inside a fixed window. Quoted from Anthem (Elevance Health)'s published policy (a page written for health care providers (Virginia Medicaid plan)), checked 2026-08-25. It is brand-level and applies to Community Insurance Company(Anthem BCBS) in Ohio the same as to every other Anthem (Elevance Health) entity in the file.
| Denial scenario (Anthem (Elevance Health)'s wording) | Who appeals it |
|---|---|
| Claim payment dispute (finalized claim, provider disagrees) | Your provider |
| Pre-service denial of a service (no claim yet) | Your provider |
Operational facts from the same policy
- Reconsideration window (VA example): 365 calendar days from the EOP
- Appeal window (VA example): 15 months of the date of service or 180 days from the reconsideration decision
- Resolution clocks (VA example): reconsideration ~30 days (+30 extension), appeal ~60 days (+60 extension)
- Submission routes (VA example): Availity Payment Appeal Tool, or by mail
- One reconsideration per claim: single shot at step one
- Member appeal window (VA example): 60 days from the denial , Member-side second source for the same Virginia HealthKeepers Plus plan as the provider manual. Medicaid member windows are short — 60 days here vs the 180-day commercial norm. No conflict with the provider-side 365-day reconsideration window: different audience, different clock.
- Member submission routes (VA example): portal/Sydney Health app, phone 800-901-0020 (TTY 711), fax 855-832-7294, or mail
- Representative needs written consent: friend, family member, doctor, or attorney — with written consent
Sources: Anthem (Elevance Health), "Provider manual excerpt — claim payment disputes (Anthem HealthKeepers Plus, Virginia)", quoted, not paraphrased; audience: health care providers (Virginia Medicaid plan); checked 2026-08-25. Anthem (Elevance Health), "Grievances and appeals — member page (Anthem HealthKeepers Plus, Virginia Medicaid; undated page)", quoted, not paraphrased; audience: members (Virginia Medicaid plan); checked 2026-08-26. Brand-level policy, applied here because Community Insurance Company(Anthem BCBS) is an Anthem (Elevance Health) entity. Your own denial letter and plan documents govern your specific case.
Questions
Is Community Insurance Company(Anthem BCBS)'s denial rate in Ohio high?
8.3% against a national average of 18.7% across the plans in this dataset. It is at or below average. A denial rate describes the insurer, not the merits of your claim.
How many people appealed a Community Insurance Company(Anthem BCBS) denial in Ohio, and how many won?
841 internal appeals were filed against 294,314 denials, and 26.75% of them were overturned (225 claims). How many went on to independent external review is not on the record for Community Insurance Company(Anthem BCBS) in Ohio, that is the absence stated at the top of this page and sourced at the foot of it.
How does Community Insurance Company(Anthem BCBS) compare with other insurers in Ohio?
Of the 10 insurers in Ohio with a reported denial rate, Community Insurance Company(Anthem BCBS) ranks 10 highest at 8.3%. The highest in Ohio is Oscar Buckeye State Insurance Corp. at 26.5%; the lowest is Community Insurance Company(Anthem BCBS) at 8.3%.
What does Community Insurance Company(Anthem BCBS) deny most often in Ohio?
No denial-reason breakdown was reported for Community Insurance Company(Anthem BCBS) in Ohio. The reason Ohio's insurers recorded most often is administrative reason, 951,084 claims, and that is the state's mix, not this company's.
How long do I have to appeal a Community Insurance Company(Anthem BCBS) denial in Ohio?
Generally 180 days from the date on the denial notice to file the internal appeal, then generally four months from the final internal denial to request independent external review. Expedited review, decided in about 72 hours, is available where delay would seriously jeopardize your health. Those timeframes are federal, so they are identical for every insurer reporting in Ohio, Community Insurance Company(Anthem BCBS) included, what varies by state is who runs the independent review at the end. Your own denial letter states the deadlines that govern your plan; that letter is the authority.
Does appealing a Community Insurance Company(Anthem BCBS) denial in Ohio cost anything?
The internal appeal to Community Insurance Company(Anthem BCBS) is free. External review is free under the HHS-administered federal process; where an issuer uses a contracted independent review organization or a state process, any fee is capped at $25 per review. Nobody in Ohio can be charged more than that to file one.
Can Community Insurance Company(Anthem BCBS) ignore an external review decision in Ohio?
No, and that is the whole point of the stage. External review decisions are binding on the plan by law. The count is the one this page names as absent for Community Insurance Company(Anthem BCBS) in Ohio, so none is printed for it, an absent figure is not a count of none.
Community Insurance Company(Anthem BCBS) sits at 8.3% in Ohio against 18.7% nationally, and that is the whole of what this page can honestly tell you about your own claim. I am not going to tell you that you will win. This page prints the insurer's own reported numbers whichever way they fall. If what it says does not match the letter in your hand, write to me and I will correct the page.
, Andrew at Axion Labs · hello@getaxionlabs.comEverything you need for your Community Insurance Company(Anthem BCBS) appeal in Ohio: your two deadlines, the argument that fits your denial reason, the letters, the clinician brief, and the external review request. One payment. No subscription. No cut of your claim. Opens on screen the moment you pay. 14-day refund, no questions, one email to hello@getaxionlabs.com.
The Community Insurance Company(Anthem BCBS) figures on this page, the 8.3% denial rate, the 294,314 denials, are this issuer’s own reported rows in that file. CMS did not report an external-review figure for Community Insurance Company(Anthem BCBS) in Ohio in the plan-year 2026 release of the Transparency in Coverage file, which is why no external-review count appears above.
Counts: CMS Transparency in Coverage Public Use File (PY2026 release, PY2024 claims), data.healthcare.gov — US Government public domain. Rights and timeframes: 29 CFR 2560.503-1 (180 days, and your free right to the claim file) and 45 CFR 147.136 (4 months, and what qualifies), explained at HealthCare.gov. Expedited review is decided in about 72 hours under both sections.
Reading either regulation from a script rather than a browser: eCFR answers automated fetches with a challenge page, so the same two sections are mirrored as government PDFs at govinfo.gov (29 CFR 2560.503-1) and govinfo.gov (45 CFR 147.136).