Financial and Provider Reconsiderations

Financial

We want to make your interactions with BlueCross BlueShield of South Carolina as easy and efficient as possible. Use these forms to save time and costs for your practice.

Provider Reconsiderations

In order to better assist our providers, we’ve created provide reconsideration forms for various medical necessity and billing disputes. Before submitting a provider reconsideration, please review the guidelines to determine what's needed to submit one.

  • Dental Provider Reconsideration Form – Use this form to request review of a dental claim that has processed with an adverse determination. This form is applicable to State Dental and BlueCross commercial dental plans only. 
  • Dialysis Erythropoietin (EPO) Appeal Request Form – Use this form when providing medical documentation to support medical necessity dosage given. 
  • Provider Reconsideration Form – Use this form to request review of a claim that has processed with an adverse determination. It ensures the medical information and supporting documentation you fax or mail gets to the right area at BlueCross. You can also use this guide to help you.  
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