Name of Manual - Blue Cross and Blue Shield of Minnesota

Appeals
Coding Appeals
(continued)
Once received, the inquiry or appeal will be reviewed and if
necessary, forwarded to the Integrated Health Management
department for determination. The review may result in approval
or denial of the claim, based on review of the information
submitted.
Note: Requests to add modifier -24, -25 or -59 to a denied service
must be submitted as replacement claims. All supporting
documentation must also be attached to the replacement
claim.
Appeal requests may be faxed or mailed.
Send your appeal request to the following address:
Blue Cross and Blue Shield of Minnesota
Attn: Provider Coding Appeals
P.O. Box 64560
St. Paul, MN 55164-0560
Fax appeal requests to: (651) 662-2745
BlueCard ® Appeals Appeals for BlueCard claims are handled through Blue Cross.
BlueCard Appeal vs.
Adjustments
Appealing Claims
Processed by the
Member’s Plan
Generally, you will not find the appeal process any different. If
coordination is required with the member’s Plan, we will
coordinate it. Appeals for timely filing of BlueCard claims must be
submitted to the patient’s Blue Plan.
BlueCard requires that for the following circumstances, new
claims must be submitted. Adjustments /appeals cannot be
reviewed in these instances:
Change an incorrect Individual Provider Number or NPI
Change an incorrect member ID number, including alpha
prefix
Claim was sent in for a patient that is not yours
Claims that are returned to you with either a yellow or green
form attached
Appeals for claims processed by the member’s plan are also
handled by them. However, you should send a completed AUC
Appeal Form and the applicable attachments to Blue Cross and we
will work with the member’s plan to facilitate your request.
10-6 Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (06/19/12)