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Appeals

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Is the appeal new or does it already exist?

appeals

New appeal

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Complete the Member appeals form.

Do you have the appeal or claim number? *

Appeal Choice

Yes

Enter the appeal or claim number.

Appeal or claim number *

Is this appeal regarding a claim for you? *

Appeals for

Yes

Let's get some information.

Are you looking for:

Benefits chosen

Behavioral Health

Labs

Benefits chosen

Surgery

Physical therapy

Benefits chosen

X-ray

Other benefits

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Is this benefit or coverage question for you?

Benefits for

Yes

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Are you looking for:

Billing chosen

Billing or payment status

Billing process

Check it Out^® form

Billing chosen

The amount of your monthly premium

Premium amount

Billing chosen

Your monthly premium due date

Do you have the invoice or statement number? *

Invoice chosen

Yes

Enter the invoice or statement number *

Invoice/statement number *

Is this invoice for you? *

Invoice For

Yes

Is this premium for you?

Is this monthly payment for you?

Is this scheduled payment for you?

Is this application for you?

Is this question for you?

Billing For

Yes

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Are you looking for:

Claims for

Claim status

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International Claim

Do you have the claim number?

Existing claim

Yes

Claim number *

Is this claim for you?

Dependent claim

Yes

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Are you looking for:

Enrollment benefits

Information about your benefit plan

My member information is incorrect

Coverage levels included in your plan

Who is covered on your plan or contract

Other benefit plan help

Is this question for you?

Enrollment Question For

Yes

Let's get some information.

Are you looking for:

Drug benefits

Your drug benefits

Help with packaging

How to get home delivery

What your out-of-pocket cost is

A pharmacy or drugstore

Help with a prescription

Other drug help

Check out your drug benefits or give us some more details.

Is this question for you?

Drug question

Yes

Are you shopping for a plan or looking around for benefit information?

Go to our Shop page, or visit our Capital Blue Cross Connect stores online or in-person or call 800.451.1181 to speak to a Sales Agent.

Already one of our providers?

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You can log in to your secure account to view or request an ID card.

Are you looking for:

ID Cards

How to request member ID cards

How to view your member ID card

Other ID card help

Is this request for your ID card?

Id Card Question For

Yes

Check out our MyCare Finder to search for providers, facilities and pharmacies and to estimate treatment costs.

Or are you just visiting, or shopping for a plan?

Select a network to see participating doctors and facilities.

Provider finder

Can't find your doctor in our network, or have a question?

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Is this question for you?

Find a Doctor question

Yes

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Are you looking for:

EOBS

How to request electronic EOBs

How to request a paper EOB

How to view an EOB

An electronic EOB that wasn't received

Other EOB help

Request paperless medical EOBs in the preferences section, view them in the claims section, or give us some more details.

Access claims EOBs in the claims section of your secure account or give us some more details.

Is this question for you?

EOBS question

Yes

Who is this for?

First name *	Middle initial	Last name *	Suffix
Date of service

What's your name?

First name *

Middle initial

Last name *

Suffix

If you can, please fill out this information.
Benefit		Drug name

If you can, please fill out this information.
Effective plan date		Term date
Plan chosen

If you can, please fill out this information.

Date of service

Method of payment

Amount of payment

Provider name

Tell us what's going on. *

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Choose the category that best describes your question.

Let's get some information.

Is the appeal new or does it already exist?

Complete the Member appeals form.

Do you have the appeal or claim number? *

Enter the appeal or claim number.

Is this appeal regarding a claim for you? *

Let's get some information.

Are you looking for:

Check out your benefits or give us some more details.

Is this benefit or coverage question for you?

Let's get some information.

Are you looking for:

Do you have the invoice or statement number? *

Enter the invoice or statement number *

Is this invoice for you? *

Is this premium for you?

Is this monthly payment for you?

Is this scheduled payment for you?

Is this application for you?

Is this question for you?

Is this question for you?

Let's get some information.

Are you looking for:

Do you have the claim number?

Is this claim for you?

Let's get some information.

Are you looking for:

Is this question for you?

Let's get some information.

Are you looking for:

Check out your drug benefits or give us some more details.

Is this question for you?

Are you shopping for a plan or looking around for benefit information?

Already one of our providers?

Let's get some information.

Let's get some information.

You can log in to your secure account to view or request an ID card.

Are you looking for:

Is this request for your ID card?

Check out our MyCare Finder to search for providers, facilities and pharmacies and to estimate treatment costs.

Or are you just visiting, or shopping for a plan?

Can't find your doctor in our network, or have a question?

Let's get some information.

Is this question for you?

Let's get some information.

Are you looking for:

Request paperless medical EOBs in the preferences section, view them in the claims section, or give us some more details.

Access claims EOBs in the claims section of your secure account or give us some more details.

Is this question for you?

Who is this for?

What's your name?

If you can, please fill out this information.

If you can, please fill out this information.

If you can, please fill out this information.

Tell us what's going on. *

How can we reach you?

Can we leave a message?

We have received your request.

Requests are reviewed Monday through Friday, 8:00 AM through 4:30 PM.

Thank you.