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Click ‘Get Form’ to open the mi bcbs appeal in the editor.
Begin by entering the 'Date submitted' in the designated field. Ensure this date is within 180 days of the original remittance advice.
Check the appropriate box for your line of business: Medicare Plus Blue, BCN commercial/BCN Advantage, or Blue Cross commercial.
Fill in the 'Individual provider name' and 'Individual provider NPI' fields. Both are essential for processing your appeal.
Complete the member's details including 'Member name', 'Member contract number', and 'Date of service'.
Input the 'Claim number' and up to three procedure codes being appealed, along with their corresponding explanation codes.
Provide a detailed rationale for your appeal in the designated section, and attach any supporting documentation as needed.

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How long do you have to file an appeal with Blue Cross Blue Shield?

Initial disputes must be submitted within 365 days, or the time specified in the providers contract, whichever is greater, of Blue Shields date of contest, denial, notice, or payment.

What is the BCBS lawsuit in Michigan?

For a standard appeal: We will give you our answer on a request for a medical item or service within 30 calendar days for pre-service (services you have not received yet) or 60 calendar days for post-service (for claims after you receive service) after we receive your appeal.

What is the timely filing limit for BCBS Michigan appeal?

Mail this completed form to Blue Cross and Blue Shield of Michigan, 600 E. Lafayette Blvd., M.C. 1620, Detroit, MI 48226-2998, or fax it to 877-522-4767.

How to file an appeal with BCBS of Michigan?

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.

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