Claim issues & disputes
We may be able to help remedy a claim issue before you file a formal dispute. Your options are:
- Correcting a claim
Submit corrected claims within 30 working days of receiving a request for missing or additional information. - Making an inquiry or contacting Provider Service
If you have questions about a specific claim, contact us.
The dispute process is reserved for requesting payment reconsideration for claims that have been denied, paid at less than billed charges, or otherwise contested.
File a dispute online
To file a dispute online, ask your account manager to give you access to all claims under your provider tax IDs.
Log into Provider Connection to start the process.
Enter the claim number associated with your dispute to start the process.
Have a question? See FAQs or step-by-step instructions.
Note: Non-medical claims do not qualify for this provider dispute process.
Submitted disputes
Get information about disputes you've submitted within the last 5 years.
For Blue Shield of California Promise Health Plan providers
Learn about the dispute process for Blue Shield Promise providers.
Refund requests for Blue Shield of California providers
Get information on scenarios that might result in overpayments and how to process refund requests.
Professional fee schedule for Blue Shield of California providers
Search the professional fee schedule for Blue Shield of California allowances and learn how we establish them.
Payment policies and rules
Read an overview of payment processing policies and rules.
File a dispute by mail: Find paper dispute resolution forms, filing instructions, and mailing addresses. Get forms and instructions
Disputes covered by the No Surprise Billing Act: The act requires that insurers and out-of-network providers resolve medical service and emergency room facility claims via open negotiation. Submit the Open Negotiation Notice form to initiate the process.