Medicare AdvantageAdministrativeMedium impact
MAPAP233 - Medicare Advantage Payment Dispute Resolution Process for Non-Contracting Providers - Updated timeframs and verbiage
Blue Cross of Idaho·ID·Reimbursement
Effective date
Dec 1, 2024
We identified it
Jun 19, 2026
Summary
Blue Cross of Idaho updated their Medicare Advantage payment dispute resolution process for non-contracting providers, revising timeframes and verbiage. The policy clarifies that non-contracting providers can dispute payments they believe are less than traditional Medicare rates, with a 90-day dispute window and 30-day response time from the plan.
Action Required
Immediately: Billing team should update dispute procedures to ensure payment disputes for Medicare Advantage claims are filed within 90 days of remittance date. Contact Blue Cross of Idaho at 208-286-3602 or 866-283-5723 for disputes, or mail to Blue Cross of Idaho Provider Appeals, P.O. Box 7408, Boise, Idaho 83707. Include supporting documentation such as Medicare remittance advice when disputing payments believed to be less than traditional Medicare rates.