Get clinical editing appeal form

MEMBER APPEAL FORM Blue Cross Blue Shield of Michigan will accept your request for an appeal when the request is submitted within 180 days from the initial denial notification.

MEMBER APPEAL FORM Blue Cross Blue Shield of Michigan will accept your request for an appeal when the request is submitted within 180 days from the initial denial notification.

You have 180 days from the date of discovery of a problem to file a grievance with, or appeal a decision of, BCBSM.

You have 180 days from the date of discovery of a problem to file a grievance with, or appeal a decision of, BCBSM.

You must file your appeal within 60 calendar days from the date on the Notice of Action letter.

You must file your appeal within 60 calendar days from the date on the Notice of Action letter.

BCBS has a 365 day timely filing limit. That means that you have 365 days to submit the claims for your client to BCBS and are eligible for processing.

BCBS has a 365 day timely filing limit. That means that you have 365 days to submit the claims for your client to BCBS and are eligible for processing.

For Medicare Plus Blue claims, Explanation of Payment codes 852, 870 and 871 are the only EOP codes that indicate that a claim has been denied for clinical editing. If you see these EOP codes on the Remittance Advice, you can submit a clinical editing appeal.

For Medicare Plus Blue claims, Explanation of Payment codes 852, 870 and 871 are the only EOP codes that indicate that a claim has been denied for clinical editing. If you see these EOP codes on the Remittance Advice, you can submit a clinical editing appeal.

MEMBER APPEAL FORM Blue Cross Blue Shield of Michigan will accept your request for an appeal when the request is submitted within 180 days from the initial denial notification.

MEMBER APPEAL FORM Blue Cross Blue Shield of Michigan will accept your request for an appeal when the request is submitted within 180 days from the initial denial notification.

You can use the Member Appeal Form (PDF) to submit your appeal. The form is optional. You can use it by itself or with a formal letter of appeal. You can select someone to act on your behalf at any step of the grievance and appeals process, including your physician.

You can use the Member Appeal Form (PDF) to submit your appeal. The form is optional. You can use it by itself or with a formal letter of appeal. You can select someone to act on your behalf at any step of the grievance and appeals process, including your physician.

If a dispute involves a lack of a decision, it must be submitted within 365 days, or the time specified in the provider's contract, whichever is greater, after the time for contesting or denying a claim has expired.

If a dispute involves a lack of a decision, it must be submitted within 365 days, or the time specified in the provider's contract, whichever is greater, after the time for contesting or denying a claim has expired.

There are two ways to file an appeal or grievance (complaint): Call Member Services at 1-877-860-2837. If you do not speak English, we can provide an interpreter at no cost to you. If you are hearing impaired, call the Illinois Relay at 711.

There are two ways to file an appeal or grievance (complaint): Call Member Services at 1-877-860-2837. If you do not speak English, we can provide an interpreter at no cost to you. If you are hearing impaired, call the Illinois Relay at 711.

The easiest way to start an appeal is by calling the number on the back of your member ID card. Or you can send us a letter or fax.

The easiest way to start an appeal is by calling the number on the back of your member ID card. Or you can send us a letter or fax.