Denials, appeals and grievances

Find appeal teams, faxes and mailing addresses. Use the denial notice to confirm the appeal level, filing deadline and recipient.

appeals grievances

Commercial administrative appeals — mailing address

Official page read

Phone

No phone listed for this route

Published hours

Not published in this record

Product, plan and location

commercial
Maryland · District of Columbia · Virginia

Mailing address

Mail Administrator P.O. Box 14114 Lexington, KY 40512-4114

Commercial administrative appeals

Written appeals on office letterhead within 180 days/6 months of the EOB; answered in writing within about 60 days. Do not use a PIRF for appeals; inquiries go through CareFirst Direct.

View source ↗ · Source checked 2026-10-25

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appeals grievances

Commercial clinical appeals — Clinical Appeals and Analysis Unit (CAU)

Official page read

Phone

No phone listed for this route

Published hours

Not published in this record

Product, plan and location

commercial
Maryland · District of Columbia · Virginia

Mailing address

Clinical Appeals and Analysis Unit (CAU) CareFirst BlueCross BlueShield P.O. Box 17636 Baltimore, MD 21298-9375

Commercial clinical appeals

Clinical (medical necessity) appeals for commercial lines of business.

View source ↗ · Source checked 2026-10-25

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Help the next office

How did your call go?

Share a structured call experience or flag a contact correction. Submissions are reviewed before publication. Patient details, recordings and documents do not belong here.

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Contact you calledWhen you called (your local time)

Minutes until a person answered / you stopped waitingOutcome

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Suggest a contact correction

Suggest a correction

Contact to correctWhat needs correcting?Proposed public informationOfficial page that supports the correctionThis is public organization information only. I have not included patient, member, claim or private contact details. Privacy notice.

Call preparation · editorial guide

Make the call count.

Find appeal teams, faxes and mailing addresses. Use the denial notice to confirm the appeal level, filing deadline and recipient.

Have ready in your secure workspace

Denial notice, remittance and reason codes
Previous appeal confirmation and decision
Supporting evidence and any required authorization to represent the member

Questions to resolve

Is this a claim correction, provider dispute or member appeal?
What deadline and submission channel apply to this case?
How can the office confirm receipt and track the decision?

This is a general administrative checklist, not payer policy or advice about a particular patient. Confirm the current plan instructions.

For healthcare offices

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For the people making the calls

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A request does not create an account or start a call. Use business contact information only. No patient information.