Banner Health Employee Benefits - Resources  

Appeal Guidelines for Banner Health and Dental Plans

 

If you have received a denial, please send in a written request stating what you are appealing. For your appeal to be processed, the following information must be included:

  • Patient name
  • Patient ID 
  • Mailing address
  • Contact phone number
  • Reason for appeal (Full details)
  • Date of service and amount (if applicable)  
  • Claim or authorization reference number (if applicable)  
  • Be sure to include any other information to support your request for appeal 

Submit your letter of appeal and supporting documentation as follows:

Cigna Dental Plans

Cigna Dental
P.O. Box 188037
Chattanooga, TN 37422

Banner Health Savings medical plan

Medical Appeals and Grievances Department
BCBSAZ Mail stop A116
P.O.Box 13466
Phoenix, AZ 85002-3466
Fax: (602) 544-5601
Phone: (602) 544-4938 or (866) 595-5998

If you are filing this appeal on behalf of someone else who is over the age of 18 years, please have them sign and date the Authorization to Use or Disclose Protected Health Information Form. Due to HIPAA regulations, we cannot process an appeal without this signed form.

View the Plan Documents for more information, or contact Blue Cross Blue Shield at (855) 801-4637.

Choice Plus or Select medical plans or any other benefit issues

Banner Plan Administration 
ATTN: Health Care Appeals (medical) or Benefit Appeals (or Health Care Appeals) 
P.O. Box 16423
Mesa, AZ 85211‐6423 

Or fax to:

Health Care Appeals (medical): (480) 684-5911  
Include  “ATTENTION: Health Care Appeals” on the cover sheet.

Benefit Appeals (all other issues): (480) 684‐6966
Include “ATTENTION: Benefit Appeals” on the cover sheet.

If you are filing this appeal on behalf of someone else who is over the age of 18 years, please have them sign and date the Authorization to Use or Disclose Protected Health Information Form. Due to HIPAA regulations, we cannot process an appeal without this signed form.

View the Plan Documents for more information, or contact the Service Center at (480) 684‐7070 in the Phoenix metropolitan area or (800) 827-2464 for all other areas.

Banner Health Employee Benefits
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These pages are highlights of the benefit plans. In the event of a difference between these pages and the legal documents/contracts, the legal documents/contracts will rule. Banner Health reserves the right to change, amend or discontinue all or part of these plans at any time for any reason. View Plan Documents
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