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Blue Cross and Blue Shield of Alabama has an established appeals process for providers. The following documentation provides guidance regarding the process for appeals.
Provider Post-Service Appeal Form: Use this form for all of your appeal requests including claims reconsideration, reimbursement and medical necessity. Be sure to provide all of the required information as indicated, including a provider signature.
Providers are required to file all post-service appeals to their local Blue Cross Plan regardless of the member's Home Plan. For example, if an Alabama physician provides services to a member with Blue Cross and Blue Shield of Kansas coverage and a post-service appeal is needed, the physician should fill out the form above and submit it to Blue Cross and Blue Shield of Alabama.
Attach any additional information and/or medical records at the time of filing the appeal for consideration.
Pre-service and concurrent appeals should continue to be submitted to the member’s Home Plan.
If you have not received a response to your submitted appeal after 30 days, you may contact Provider Customer Service to verify the status of your appeal.
For more information about the appeals process, view the Q&A documents listed below: