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

1. Within 90 days of claim adjudication date, complete and submit the provider commercial appeal form. 
2. Mail completed appeal form and any supporting documents to:
   
   Blue Cross NC
   Provider Appeal Department
   PO Box 2291
   Durham, NC 27702
   
   Or fax the completed form and supporting documents to:
   
   Billing / coding denials: 919-287-8708
   Medical necessity / administrative denials: 919-287-8709
   
   Provider commercial appeal form (PDF)

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

Instructions

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

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