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Billing Dispute External Review Process (BDERP)

Effective Nov. 21, 2008, Medical Doctors/Doctors of Osteopath (MDs/DOs) may file a Post-Service Provider Appeal to resolve disputes limited to the application of coding and payment rules and methodology related to ClaimCheck, bundling, modifiers, etc. The Blue Cross and Blue Shield of Illinois Internal Appeal process must be exhausted before an External Appeal will be considered. The Provider Appeals are conducted by MES Solutions, an Independent Review Organization.

An appeal can be submitted via Web, fax or mail. The guidelines for submitting an Appeal and the applicable fees can be found on the MES Solutions website.