New Provider Appeals Forms

To ensure that appeals are received in a timely manner, use the new forms to submit an appeal instead of the old forms or no forms at all. Make sure you select the appropriate form to address your specific need: PRO-80 Claims Reconsideration Form, PRO-81 Professional Reimbursement Appeal Form or PRO-82 Utilization Management Appeal Form.

Source: https://providers.bcbsal.org/portal/resources?p_auth=qj3ISuph&p_p_id=resourcesportlet_WAR_webcontentportlet&p_p_lifecycle=1&p_p_state=normal&p_p_mode=view&p_p_col_id=column-2&p_p_col_count=1&_resourcesportlet_WAR_webcontentportlet_action=expandResource&p_r_p_633009435_categoryId=268753&_resourcesportlet_WAR_webcontentportlet_expanded=false