Complaints & appeals
How to file an appeal
Before filing an appeal, call customer service at the number on the back of your member ID card to find out why the claim was denied. If, after talking with customer service, you decide to file an appeal, use the form specific to your coverage plan. Download the appropriate form below.
Fully insured or self-insured?
Your plan is fully insured if you have Medicare supplemental coverage individual coverage. If you’re covered through your employer, ask your human resources representative whether your plan is fully insured or self-insured.
Review of a complaint or appeal
If you aren’t satisfied with the result of your appeal, click the Independent Review tab to find out about requesting an independent review.
Complaints about privacy protection
If you have a complaint about Blue Cross’ privacy protection practices or feel that Blue Cross has not complied with the terms of its Notice of Privacy Practices, you have the right to file a complaint. Download the form below.
Blue Plus complaint/appeal form (PDF)
Fully insured complaint/appeal form (PDF)
Self-insured complaint/appeal form (PDF)
Blue Advantage/MinnesotaCare grievances/appeals – see page 4 (PDF)
SecureBlue (HMO SNP) grievances/appeals (PDF)
Privacy practices complaint form (PDF)
Get Acrobat Reader 
Independent review
If you disagree with an action taken by Blue Cross and Blue Shield of Minnesota, call customer service for an explanation at the number listed on the back of your member ID card. If you aren’t satisfied with the explanation, you may request a review of your concerns. An independent review organization works with health plans and their members to review claims that have been denied.
Requesting a review
Complete a complaint form and send it to us.
Once you have completed our internal review process, if your complaint relates to a health care service or claim and you disagree with our decision, you may submit your complaint for external review by an independent review organization, the Center for Health Dispute Resolution.
Your written request for review must be submitted to the state commissioner along with a $25 filing fee. The commissioner may waive the fee in cases of financial hardship.
You may designate an individual to act on your behalf. You must make your designation in writing.
Questions?
If you have questions about the external appeal process, contact one of the following offices:
- The Minnesota Department of Commerce — 1-800-657-3602
- The Minnesota Department of Health — 1-800-657-3916
Important: If you are covered by a self-insured plan
State review guidelines do not apply to some self-insured plans. After you have completed our internal complaint and appeal process, review your summary plan description for any further appeal options.