All Other Appeals
If an appeal does not fit into any of the three categories listed above, it is considered an appeal type of
“Other.” Examples include but are not limited to:
• Out-of-network provider requesting additional payment without changing the claim’s original billing
information.
• Claims denied as being outside the provider’s scope of service or contract
• Claims denied as services not payable under provider agreement
• Claims denied as services are not eligible for reimbursement
Appeals should be sent to the address below with the following information:
• The completed Provider Appeal Form (available at www.bcbsfl.com).
• A copy of the remittance advice.
• The necessary medical documentation (e.g., operative report, physician orders, history and physical)
as indicated by the reason for the reduction or the denial on the remittance advice.
Send appeals (excluding HMO behavioral health appeals) to:
Blue Cross and Blue Shield of Florida
P.O. Box 1798
Jacksonville, FL 32231
HMO Behavioral Health Appeals
All HMO behavioral health appeals are coordinated through MHNet. Send appeals to:
MHNet
Appeals Department
1211 State Road 436
Casselberry, FL 32707
