Claims questions and appeals

If you have a question about payment you received for services provided to a Medicare Plus Blue PFFS^SM or Medicare Plus Blue PPO^SM 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.

 

For Medicare Plus Blue PFFS, see terms and conditions for more information.

 

For Medicare Plus Blue PPO, refer to the Medicare Plus Blue PPO manual (PDF) for more information.