Get Blue Cross Blue Shield Of Texas Claim Review Form 2015-2025

All claims must be resolved with 365 calendar days from the date of service or discharge date. This applies to capitated and fee-for-service claims.

If you have any questions about the submission process or about your claim, you can call a BCBSTX Personal Health Assistant toll-free at (800) 252-8039 (TTY:711), Monday-Friday 7 a.m.-7 p.m. and Saturday 7 a.m.-3 p.m. CT.

All claims must be submitted within 180 days of the date of service. When the required information is not included, the claim will be denied. A new claim with correct and complete information must be submitted in order for a denied claim to be reconsidered.

How to File an Appeal Fill out a Health Plan Appeal Request Form. Mail or fax it to us using the address or fax number listed at the top of the form. Call the BCBSTX Customer Advocate Department toll-free at 1-888-657-6061 (TTY: 711), Monday through Friday, 8 a.m. to 5 p.m., Central Time.

Participating physicians, professional providers, ancillary and facility providers are requested to submit claims electronically to Blue Cross and Blue Shield of Texas (BCBSTX) within 95 days of the date of service, or by using the standard CMS-1500 or UB04 claim form.

If you submit your claim more than 18 months after the date of service, your claim will be denied, and benefits will not be paid to you or your provider. When your health care claim has been processed, you will get an Explanation of Benefits (EOB) or a claims letter.