​​​We continue to receive a high volume of claim review requests inappropriately sent to the member appeals fax number.

Note: Misdirected requests will delay process​ing.

DO NOT use the appeals fax number to submit medical records not related to a member appeal or to request the status of a Claim Investigation.

Providers and their third-party vendors must adhere to the proper submission channel for claim review requests. Please work with your third-party vendors to ensure they are aware of the proper submission procedures.

Process for submitting claims-related issues

• Use the Practice Management application on the Provider Engagement, Analytics & Reporting (PEAR) portal to submit a Claim Investigation request via the Claim Search transaction.
• Review the Claim Search & Investigation user guide in the PEAR Help Center for assistance.

Process for submitting provider appeals

Provider appeal requests must be mailed to Independence Blue Cross (IBX) or Independence Administrators as outlined below and in the Appeals section of the Provider Manual or the Clinical Services – Utilization Management section of the Hospital Manual.

• IBX Medical Necessity appeals
  Facility Appeals
  P.O. Box 13985
  Philadelphia, PA 19101

• IBX Provider Billing Disputes and/or Grievances
  Provider Billing Disputes
  P.O. Box 7930
  Philadelphia, PA 19101-7930
  
  Provider Grievances
  P.O. Box 7930
  Philadelphia, PA 19101-7930

• Independence Administrators appeals
  Appeals Department
  P.O. Box 21974
  Eagan, MN 55121

 
IMPORTANT: Do not use the member appeals fax number unless you are submitting an appeal on the member's behalf.

Examples of when the fax number can be used include:

• Provider appeals on behalf of the member with a valid member consent form.
• Expedited preservice appeals on behalf of the member.

Thank you in advance for ensuring the appropriate channel is used when submitting future requests.

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