Claim Inquiry Form

Select the most accurate reason for this inquiry

Allowable Questions
Billed in Error / Void
Complete Medical Records Request
Corrected Claim
Lab Service Denial
Overpayment
Prior Authorization Denial
Other

Prior Authorization Denial

Failure to obtain Prior Authorization approval may result in the denial of payment. If you need additional information about which procedures and medications require authorization for any particular member, visit our Prior Authorization page.

Prior Authorization Requirements Continue to Inquiry Form

APEA Lab Service Denial

Claims for lab services completed at office, hospital outpatient, or independent lab locations have been processed according to Blue KC's updated medical policies. For more information, visit the Blue KC Medical Policies page and type "APEA" into the text field at the top. This will filter your list to display our policies related to specific lab services.

View Medical Policies Continue to Inquiry Form

Help us understand how we can help you

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Patient Information – Who received care?

All fields in this section are required.

Patient Name

Member ID

Medicare Advantage: Enter 00 in Suffix field.
Federal Employee Prgm: Enter NA in Prefix field.

Group ID

Patient Date of Birth

Claim Details

All fields in this section are required.

Date(s) of Service

Claim Number

Total Charges

Have you inquired about this claim before?
No - This is my first time inquiring about this claim.
Yes - I’m checking the status. Please note that response times may take up to 30 days.
Yes - I never received a response, and it has been 30+ days since my inquiry.
Yes - I have additional questions about this claim.

Tell us more about the allowable(s) in question

Member Plan Name
Attach a copy of the applicable fee
schedule for an expedited response.

- Billing Code
- Expected Reimbursement

Health Care Provider

All fields in this section are required.

Provider's Full Name

Provider ID or NPI

Street Address

City

State

ZIP Code

Contact Name

Contact Phone Number

Contact Fax Number

Attach Supporting Documentation

Supporting documentation must clearly identify the patient’s name, Member ID number, and the date(s) of service.

PDFs or images are allowed. Press and hold the CTRL key to select and upload multiple files.

Describe the document(s) you are attaching
- Corrected Claim
- Medical Records
- Fee Schedule
- Pricing Calculation
- Other

Provide Your Email Address

An email address is required. We will email a copy to your inbox for your personal records.

Email address

If you experience issues submitting this form, please print and fax it to one of the following:

Local HMO/PPO 816-278-1944.

Blue Card 816-395-3860

FEP 816-395-3811

Or mail to:

For local business:
Blue Cross Blue Shield of Kansas City
Attn: Correspondence
PO Box 419169
Kansas City, MO 64141-6169

For Blue Card:
Blue Cross Blue Shield of Kansas City
Attn: Correspondence
PO Box 419016
Kansas City, MO 64141-6016

For FEP:
Blue Cross Blue Shield of Kansas City
Attn: Correspondence
PO Box 419071
Kansas City, MO 64179-0288

To comply with Missouri Prompt Pay Statuses 376.383 & 376.384, please indicate if you are responding to a Blue KC request for additional information.

Important: By continuing below, you agree that all information provided is accurate to the best of your knowledge. You understand that falsifying or misrepresenting essential information is a serious crime which could lead to fines or imprisonment.