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Administrative appeals or claims reviews are conducted on claim denials.
If you’d like to:
- Request a claim adjustment for a service previously reviewed, you must submit a written request to the address listed below.
- Make a correction to a previously submitted 1500 or UB-04 claim, then submit a replacement claim, not an appeal.
- Submit an appeal, send us a completed Request for Claim Review Form.
- All first-level provider appeals to request a claim review must be submitted in writing within 180 days of the initial claim being denied or processed to the appropriate address listed below.
- If you disagree with the first-level provider appeal determination, you may submit a second-level provider appeal in writing within 60 days of receipt of the first-level provider appeal determination.
Where to mail your completed documents
| Medical appeals | Dental appeals |
|---|---|
| Blue Cross Blue Shield of MA Provider Appeals PO Box 986065 Boston, MA 02298 |
Blue Cross Blue Shield of MA Process Control PO Box 986010 Boston, MA 02298 |
Claim Appeals we’re currently reviewing
| For | We are currently processing appeals received on this date* |
|---|---|
| Medicare Advantage | 09/26/2025 |
| BlueCard (outside Massachusetts) | 09/23/2025 |
| Home Infusion Therapy | 08/13/2025 |
| In-state (local), professional 1500 | 09/22/2025 |
| In-state (local), facility UB-04 | 09/23/2025 |
| Federal Employee Program - 1500 | 09/25/2025 |
| Federal Employee Program - UB-04 | 09/25/2025 |
| Timely Filing Limit | 09/17/2025 |
*Note: The date listed does not include appeals that need to be reviewed by a nurse as these may take longer to complete.
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