Administrative Reviews and Appeals
Administrative appeals/claims reviews are conducted on claim-based denials. To request a claim adjustment for a service previously reviewed, you must submit a written request.
Note: If you want to make a correction to a previously submitted 1500 or UB-04 claim, submit a replacement claim, not an appeal.
To submit an appeal, send us the Request for Claim Review Form within one year of the date the claim was denied. You can submit up to two appeals per denied service within one year of the date the claim was denied.
Completed forms should be mailed to:
| 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 |
