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Provider Dispute Form -- Confidential -- bcbst.com BlueCross BlueShield of Tennessee 1 Cameron Hill Circle, Suite 0039 Chattanooga, Tennessee 37402-0039 ? Date ? Provider Name ? Provider No./NPI ?.

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How to File an Appeal Fill out a Health Plan Appeal Request Form. Mail or fax it to us using the address or fax number listed at the top of the form. Call the BCBSTX Customer Advocate Department toll-free at 1-888-657-6061 (TTY: 711), Monday through Friday, 8 a.m. to 5 p.m., Central Time.

Whether you have questions about health insurance or you want to learn about your plan details, our Member Care Team is here for you. If you have any questions about your plan details, our Member Care Team is here for you online, or call 1-888-770-8840 (TTY: 711) , 7 days a week from 8 a.m. – 9 p.m. ET.

If you disagree with a decision we've made or if you need to provide additional information that may affect the decision, please submit a Provider Reconsideration Form to us within 18 months of the initial denial.

BlueCross BlueShield of Tennessee 1 Cameron Hill Circle, Suite 0039 Chattanooga, TN 37402-0039 For faster review and processing, fax your reconsideration request to (423) 535-1959.

You can verify benefits and request prior authorization at Availity.com or by phone at 1-888-693-32111-888-693-3211 or by fax at 1-888-693-3210.

Mail requests to: BlueCare or TennCareSelect (specify) 1 Cameron Hill Circle, Ste 0002 Chattanooga, TN 37402-0002 Services Requiring Referral Refer to Section VIII.

Phone 1-800-292-8196. 1-800-292-8196. TRS users should call: 711 (Ask for 888-418-0008) TRS users should call: 711 (Ask for 888-418-0008) EMAIL US.

If you have a complaint about a service or care you received from Blue Cross and Blue Shield of Texas (BCBSTX) or one of our providers, please call a Customer Advocate at 1-888-657-6061 (TTY: 711).

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232