Appealing Administrative Denials

Administrative appeal requests must be submitted to Blue Cross and Blue Shield of Nebraska (BCBSNE) within 45 calendar days of the provider’s receipt of the denial decision. Documentation submitted must include a written appeal request along with the rationale and supporting documentation, if applicable, related to the denial and any other information pertinent to the request. BCBSNE notifies the provider of the decision within 30 calendar days of receiving all necessary information. 

Providers should mail appeal requests related to Administrative denials, inpatient to the following address:  

Blue Cross and Blue Shield of Nebraska 
Attn: Appeals Department 
P.O. Box 3248 
Omaha, NE 68180-0001 

The decision regarding the administrative determination appeal process is final. If the administrative denial is overturned but a denial determination is subsequently rendered in accordance with Medicare Advantage criteria, the provider is eligible to appeal through the clinical determination appeal process described.