Extended timeframe for post-service provider appeals through November 28, 2024, for providers located in impacted disaster counties

Due to Hurricane Helene, effective immediately, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is extending the timeframe for submitting post-service provider appeals from 90 days to 180 days from the claim adjudication date for providers located in impacted disaster counties.

Provider appeals for billing/coding disputes and medical necessity claim determinations received between September 25 and November 28, 2024, will be accepted if within 180 days of the claim adjudication date.

This communication applies to State Health Plan (SHP), Administrative Services Only (ASO), Fully Insured, and Blue Medicare. It does not apply to Blue Cross and Blue Shield Association InterPlan Program (IPP) Host member claims.