How to file an appeal

When Octave Blue Cross and Blue Shield denies a claim for benefits, the member receives an Explanation of Benefits (EOB) explaining the reason for the denial. The member has the right to file an appeal to request review of the denial of a claim in whole or in part.

An appeal must be submitted in writing. The appeal should include member name, health plan ID number, a reference to the claim being appealed (such as a claim number), and date and provider of service.

When to submit an appeal

You must file an appeal within 180 days after you have been notified of the denial of benefits.

Where to submit an appeal

Send requests for review of a denial of benefits in writing.

Write on the envelope:
Internal Review Request

Mail the request to:
Appeals Coordinator
Octave Blue Cross and Blue Shield
P.O. Box 8069 
Little Rock, AR 72203-8069