Provider InterPlan Program (IPP) and BlueCard claim appeal form

Recently, the Blue Cross and Blue Shield Association (BCBSA) released a common appeal form, that will be accepted by each Blue Cross and Blue Shield plan. Due to this, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has recently added the Provider BlueCard Claim Appeal form to our website. This form is not required to initiate a request, but effective December 18, 2025, providers will have the option to use this form for InterPlan Program (IPP) and BlueCard Claim provider appeals only.

For appeals involving billing, coding, or medical necessity disputes for all other lines of business, please continue to use the Claims, Appeals, and Inquiries page on our website.  To help with timeliness and to avoid confusion, please do not initiate both forms to appeal the same claim.