Complaints & Appeals

If you'd like to make a complaint or file an appeal about a claim that was denied, call customer service at the number on the back of your member ID card. If you are unable to resolve your complaint, you can file an appeal. Start by downloading the complaint/appeal form for your health plan. Forms are available at the bottom of this page.

Review of a complaint or appeal

If you are not satisfied with the result of your complaint or appeal, you can request an independent review. See the tab "Ask for a review" for more information.

Complaints about privacy protection

If you have a complaint about our privacy practices or feel that we have not complied with the terms of our Notice of Privacy Practices, you have the right to file a complaint. You can download the form below.

More information and forms

If you're not sure which is for your health plan, call the number on the back of your member ID card.

• Medicare complaints and appeals information
• Blue Plus fully insured complaint/appeal form (PDF)
• Blue Cross fully insured complaint/appeal form (PDF)
• Blue Cross self-insured complaint/appeal form (PDF)
• Blue Advantage Families and Children/MinnesotaCare appeal rights form (PDF)
• SecureBlue (HMO SNP) grievances/appeals form (PDF)
• Privacy practices complaint form (PDF)
• Non-Minnesota / non-par provider claim adjustment / appeal form (PDF)
• Get Acrobat Reader

If you are unhappy with a decision we've made about your complaint or appeal, you may ask for additional information or explanation by calling customer service at the number listed on the back of your member ID card. If your complaint or appeal is about a health care service or claim or contract rescission, review by an independent organization may be available to you.

Important:

In most cases, you must first exhaust the internal appeal process. Plans regulated by the State of MN have a filing fee of $25, which the state may waive in cases of financial hardship.  Independent review guidelines do not apply to all plans or complaints/appeals.  To find out if you have an independent review option call the customer service number on the back of your member ID card or review a copy of your certificate of coverage for appeal options.

How to request a review

To ask for a review, please refer to the instructions included in your denial letter from the appeal process or contact the appropriate office noted below. An independent review organization will work with you and your health plan to review your claim. You can also choose someone to act on your behalf, but you must ask for this in writing.

Questions?

If you have a fully insured plan or state regulated plan, and have questions about reviews, contact one of the following offices below:

• The Minnesota Department of Commerce — 1-800-657-3602 (Blue Cross and Blue Shield of MN plan)
• The Minnesota Department of Health — 1-800-657-3916 (Blue Plus of MN plan)
• If you have a Multi-State Plan, the United States Office of Personnel Management — 1-855-318-0714 (Blue Cross and Blue Shield of MN plan)

If you have a self-insured plan or are not sure what type of plan you have, call the customer service number on the back of your member ID card.

Don't have a copy of your certificate of coverage?

Call customer service at the number on the back of your member ID card to ask for a copy.