Now submit provider disputes online

December 2, 2022

We are pleased to announce a new way to file provider disputes. You now have the option to submit disputes involving your commercial, Shared Advantage® and BlueCard® claims online, in addition to using the existing mail-in process.
 

How it works

You’ll need the claim number to get started:

• Log in, search for a claim, then from the Claim page, click the “Resolve claim issue or dispute” link at the top of the page, or
• If you already know the claim number, log in and enter it on the Claim issues and disputes page.

The online form will automatically include provider, member, and billing information taken from your claim, so you don’t have to fill it all out yourself. You may add other claims for the same type of issue to bundle them with a dispute, either one at a time for up to 20 claims, or as a list on a spreadsheet.

To complete the form, you’ll need to provide a description and any supporting documents you may want to upload – such as medical records or itemized bills – and your current contact information. Blue Shield will send important updates, as needed, to the email provided.

Checking dispute status and viewing letters

After you submit a dispute online, Blue Shield will acknowledge receipt within 2 business days via:

• A message will be sent to the email address you have provided
• An acknowledgement letter will be available to view on the Submitted disputes page

Dispute updates, requests for additional information, and determinations will be communicated in the same manner. Your dispute letters, records, and statuses will always be available to view on the Submitted disputes page. Some letters can be retrieved for six months following the date they are issued. Starting October 2022, we’re extending the period of time you can view letters online to up to two years following the initial issue date.

You may still send provider dispute resolution requests by postal mail. We hope, however, that you will use this convenient new online process to save time and reduce postage costs.
 

Registering on Provider Connection

Access to claims is required to submit provider disputes and view past records. If no one in your organization is currently registered as an Account Manager on Provider Connection, please register now and set up user accounts for your team so you will be able to submit provider disputes online.
 

Questions?

Here are some instructions to help you get started:

• Visit our provider dispute Frequently asked questions page.
• View Help section for step-by-step instructions on how to dispute a claim. Under Claims, click Dispute a claim decision online.
• For more information about the dispute resolution process, visit the Claim issues and disputes page.

If you have additional questions, please contact us.