Claims Questions and Appeals
If you have a question about payment you received for services provided to a Medicare Plus Blue℠ PPO member, contact the plan that issued the check (usually your local Blue plan).
You may appeal a denial or a payment amount if you believe the same service would have been covered, or covered at a higher payment amount, under Medicare.
Refer to the Medicare Plus Blue PPO manual (PDF) for more information.
For questions about Medicare Plus Blue PPO or Blue Cross® Medicare PFFS dental claims, please call 1-888-826-8152.
Pharmacies with questions about AWP or MAC pricing should contact BCBSM's Technical Pharmacy Help Desk at 1-800-437-3803.
For clinical editing appeals for Medicare Plus Blue PPO or to find out how the appeal process works, refer to the following documents:
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