Browse by Topic

Browse by Plan Type

Other Help

Not finding what you need in this section for members and insurance shoppers? Check out our other help sections below.

How can I resolve a problem with my Blue Cross Blue Shield of Michigan claim?

Who is this for?

Michigan Health Insurance – Customer Service – How To

If you’re a Blue Cross Blue Shield of Michigan member and have a problem with your claim, this information explains how to report it to us.

It’s important to us that you’re satisfied with the way a claim or request for benefits is handled.

If you have a problem, please call us first.

Use the phone number on the back of your enrollee ID card, or in the top right hand corner of your Explanation of Benefit (EOB) statement. We’ll do our best to help.

I talked to Customer Service, and I still have a problem. Now what?

We have a formal grievance and appeals process you can follow. It doesn’t cost you anything to file a grievance or appeal a decision.

Use the state process if you:

  • Are insured through your employer (including non-ERISA groups)
  • Buy your own insurance

You can begin this process up to two years from when the problem started.

If you’re insured through a self-funded ERISA group, you’ll use the federal process. You can begin this process up to 180 days after you get a notice from us that denies or reduces payment on a claim.

Tip: Check with your employer to find out whether the business falls under non-ERISA or a self-funded ERISA group.

Getting help fast: expedited grievance and review

There are occasions when we can speed up the grievance and appeals process. For example, if waiting would jeopardize your life or health. Choose the same process you’d use to file a standard grievance or appeal.

State process (expedited internal grievance)

Federal process (urgent internal review)

Was this content helpful?

Rate it

Submit >

One site. One stop.

Managing your health plan online
has never been easier. On the new bcbsm.com, all your account information is in one place and personalized, so it's more useful.
Even better, you can access it anytime, anywhere, from your mobile device.

I’d like to register

Log in to my account

©1996-2014 Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. We provide health insurance in Michigan.

State and Federal Privacy laws prohibit unauthorized access to Member's private information. Individuals attempting unauthorized access will be prosecuted.

Site Map  |  Feedback  |  Important Legal and Privacy Information

Explanation of Level A Conformance
Better Business Bureau Online Seal of Reliability