Get Blue Cross Member Appeal Form 2021-2024

Submit corrected claims within 30 working days of receiving a request for missing or additional information. If you have questions about a specific claim, contact Blue Shield of California Provider Services.

Timely Claims Submission Ideally, we'd like you to submit claims within 60 calendar days of the covered services, but no later than 365 calendar days. For most plans, we'll deny claims received more than 12 months after the date of service with no member responsibility.

When you're looking up a claim using member information, make sure you click on the provider name to get details like the claim receipt date, pended reasons, and claim payment codes. We process most of our claims within 30 days and we pay claims every Saturday and on the last day of the month.

Level 2 Appeal: Disagreement with the determination of the first level of appeal. Second-level appeals must be submitted in writing. Must be received within 30 calendar days from the participant's receipt of the Level 1 Appeal notification.

If you believe that Premera has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, sex, gender identity, or sexual orientation, you can file a grievance with: Civil Rights Coordinator ─ Complaints and Appeals, PO Box 91102, Seattle, WA 98111, ...

Fax general appeals to 425-918-5592.

To request a health plan appeal you can: 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.

Timely Claims Submission Ideally, we'd like you to submit claims within 60 calendar days of the covered services, but no later than 365 calendar days. For most plans, we'll deny claims received more than 12 months after the date of service with no member responsibility.