Directory information — verify before you send. This fax number was compiled by automated research from public sources. It may be out of date, incomplete, incorrect, or in rare cases wrong entirely, and it is not confirmed by Anthem Blue Cross and Blue Shield (New York BlueCross BlueShield - NYBCBS). Before sending anything sensitive, confirm the number and receiving department directly with Anthem Blue Cross and Blue Shield (New York BlueCross BlueShield - NYBCBS), and consider sending a test cover page first. FaxFlow is an independent directory, is not affiliated with, endorsed by, or sponsored by this organization, and accepts no liability for reliance on this listing.
This appears to be a financial, insurance, or legal destination. Documents sent here may contain account numbers, SSNs, or privileged information. Confirm the current number and department directly with the organization before sending, and keep your transmission confirmation.
Represent Anthem Blue Cross and Blue Shield (New York BlueCross BlueShield - NYBCBS)? Request a correction or removal. By using this directory you agree to our Fax Directory Terms.
Anthem Blue Cross and Blue Shield (New York BlueCross BlueShield - NYBCBS) fax number
(877) 278-2163
Wrong or outdated? Report this number
Provider Clinical Appeals / Grievance and Appeals Department
Used for: Retro-Service Appeal (retroactive medical necessity appeal) for denied services, via fax to 877-278-2163
Fax destination details
- Department
- Provider Clinical Appeals / Grievance and Appeals Department
- Purpose
- Retro-Service Appeal (retroactive medical necessity appeal) for denied services, via fax to 877-278-2163
- Form
- Form 102082 - Provider Clinical Appeal Request — Provider Clinical Appeal Request
- Address
- PO Box 5063, Middletown, NY 10940
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Only use this form to request an appeal for medical necessity for which you have received an initial denial letter from Utilization Management. Indicate if the date of service is retrospective, whether expedited review is requested, and provide member/denial details with supporting documentation.
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
FaxFlow records the public sources found during directory research. A source link is useful evidence, but it is not a guarantee that a number still reaches the same team.
No public source link was saved with this record. Confirm the number directly with the organization before using it.