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Claims

Frequently Asked Questions


Claims

How do I file a claim?
How long do I have to file a claim?
Where do I send my claim appeal or enrollment appeal?
How do I know if the physician I see will submit my claim?


How do I file a claim?

Claims may be submitted after you receive care or service from a physician or hospital. Many providers in our region submit claims for you. However, if you need a claim form, please call Customer Service at800.962.2242, or download a claim form from the web site.

How do I know if the physician I see will submit my claim?

Participating providers automatically submit your claim for you. Simply ask your physician's office if they submit claims to Capital BlueCross on your behalf. For a list of participating providers, visit the Provider Search section of our web site.

How long do I have to file a claim?

Generally, you have one year from the day a service is received to file a claim. Please consult your certificate of coverage for specific information.

Where do I send my claim appeal or enrollment appeal?

All appeals may be sent to:

Mandatory Appeal
Capital BlueCross
PO Box 779511
Harrisburg, PA 17177-9511