To ensure Blue Cross NC reviews your appeal or inquiry quickly, please review these instructions for a provider appeal form (PDF) and file appropriately. Submitting an inquiry as an appeal (or vice versa) will cause delays.

• File an appeal when you are disputing the billing, coding, or medical necessity of a claim.
• File an inquiry when you have a contractual dispute that is not related to billing, coding, or medical necessity.

Instructions

Provider appeals must be submitted within 90 days of the claim adjudication date using one of the following methods:

• Electronic submission
  • Use the Blue e and Care Affiliate provider portal for a streamlined and efficient process to submit your appeal along with supporting documentation.
• Fax or mail submission
  • Complete the provider commercial appeal form (PDF) and submit with supporting documentation:
    
    Fax:
    For billing / coding denials: 919-287-8708
    For medical necessity / administrative denials: 919-287-8709
    
    Mail:
    Blue Cross NC
    Provider Appeals Department
    PO Box 2291
    Durham, NC 27702-2291

If you have any questions, you can reach out to us for help submitting an appeal.

Instructions

1. Complete the general inquiry form (PDF).
2. Mail completed form to:
   Blue Cross NC
   Provider Inquiry Department
   PO Box 2291
   Durham, NC 27702-2291
   
   Or fax to 866-987-4167

If you have any questions, you can reach out to us for help submitting an inquiry.