What is the non-contract provider appeal process for Blue Medicare HMO and Blue Medicare PPO?

A non-contract provider, on his or her own behalf, is permitted to file a standard appeal for a denied claim only if the provider completes a Waiver of Liability statement, which states that the non-contract provider will not bill the enrollee regardless of the outcome of the appeal. The appeal must be in writing.

A third-party vendor cannot file on behalf of the non-contract provider. The non-contract provider must file on his or her behalf.