Claims contacts

See claims phone numbers and mailing addresses

Use of this technology can help speed receipt of payments, reduce paperwork, and improve accuracy when you submit claims, verify eligibility, obtain claim status, receive remittance advice, and receive funds transfer.

Contact us for questions about:

• EDI set-up inquiries (270/271, 276/277, 278, 837, 835)
• ERA set-up inquiries
• EFT set-up inquiries
• Member Benefit Enrollment set-up inquiries (820/834)

Call the EDI Help Desk at (800) 480-1221

HMO and PPO:

Blue Shield of California 
       Appeals and Grievances
       P.O. Box 5588
       El Dorado Hills, CA 95762-0011

Members should call the number on the back of their member ID card for appeals inquiries.

Blue Shield 65 Plus (HMO):

Blue Shield of California
       Grievance Resolution Department
       6300 Canoga Avenue
       Woodland Hills, CA 91367-2555

  Medicare Member Services, phone:(800) 776-4466
Hearing Impaired, phone:(800) 794-1099
Standard and expedited appeal fax: (916) 350-6510

Dedicated Provider appeals line:

Phone:(800) 541-6652

HMO and PPO:

Blue Shield of California Initial Appeal Resolution Office
      P.O. Box 272620
      Chico, CA 95927-2620

Blue Shield Initial Appeal Resolution Office
      Attn: Hospital Exception and Transplant Team
      P.O. Box 629010
      El Dorado Hills, CA 95762-9010

Blue Shield Final Appeal Resolution Office
      P.O. Box 629011
      El Dorado Hills, CA 95762-9011

Blue Shield 65 Plus (HMO):

Blue Shield 65 Plus
      Medicare Provider Appeals Department
      P.O. Box 272640
      Chico, CA 95927-2640
Fax: (855) 895-3501

Appeals and grievance process for Blue Shield Promise Medicare members

 Appeal process
Grievance process

Appeals and grievance process for Blue Shield Promise Medi-Cal members

 Appeal and grievance process

Appeals and grievance process for Blue Shield Promise Cal MediConnect members

 Appeal process
Grievance process

Find dispute resolution policies, procedures and contact information for Blue Shield Promise providers:

 Policies, procedures and contacts for Blue Shield Promise Medicare providers

 Policies, procedures and contacts for Blue Shield Promise Medi-Cal providers

 Policies, procedures and contacts for Blue Shield Promise Cal MediConnect providers

If you find an overpayment, notify Blue Shield by contacting the appropriate service center.

If the overpayment involves a Coordination of Benefits (COB) issue, and Blue Shield processed the claim as the primary payer in error, please send a copy of the Explanation of Benefits (EOB) from the primary payer to the appropriate service center.

Blue Shield will research the claim and advise you of the amount of overpayment.

Overpayments from Blue Shield are to be directly refunded to Blue Shield. When requested, send refund checks to the following address:

Blue Shield of California 
      Attn: Cash Receiving
      P.O. Box 241012
      Lodi, CA 95241

BlueCard provider customer services:

(800) 622-0632, 6 a.m. to 9 p.m., Monday through Friday

BlueCard resources

BlueCard program information

Verify BlueCard member's eligibility

Claims routing tool

Federal Employee Program customer services:

(800) 824-8839, 8:30 a.m. to 4:30 p.m., Monday through Friday