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    You may call us, or download the Appeal Form available on our website, highmarkbcbsde.com, and return it to us by mail. There is no cost to file an appeal.
    Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Highmark Western and Northeastern New York Inc., serves eight counties in Western New
    Cross Blue Shield Delaware’s appeal decision) 7) Provider(s) of service (doctors, labs, hospitals): Thank you for completing this form.
    Reimbursement Forms​​ Provider Claim Inquiry Form When submitting a provider inquiry for review, please submit all materials as indicated within the form.
    Note: This form is to be used by participating providers to appeal services rendered to patients with Highmark Blue Cross Blue Shield.
    This form may be sent to us by mail or fax: Address: Fax Number: Standard Redetermination: Standard Redetermination: 1-717-635-4209. Appeals & Grievance
    Forms · Provider tools and resources · Interested in becoming a provider in the Highmark BCBSWNY network? · Get emails from Highmark Blue Cross Blue Shield of
    East, and QCC Insurance Company, and with Highmark Blue Shield Independence member, providers may appeal claim denials related to general coding and the.

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