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Administrative Reviews and Appeals

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.
    This is due within one year of the date the claim was denied. You can submit up to two appeals for the same denied service within one year of the date the claim was denied.

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 07/08/2024
BlueCard (outside Massachusetts) 07/01/2024
Home Infusion Therapy 04/10/2024
In-state (local), professional 1500 06/26/2024
In-state (local), facility UB-04 06/26/2024
Federal Employee Program - 1500 07/08/2024
Federal Employee Program - UB-04 07/08/2024
Timely Filing Limit 06/28/2024

  Video: Appeal Status (2 min)

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