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Provider Fraud Inquiry

For the quickest, most accurate response, please fill in as much information as possible. We will respond to you by e-mail. (* denotes required fields).
** Please note: Status of estimated resolution dates for claims processing, both new and adjustments (including reconsiderations), can be found on NaviNet. Please refer there BEFORE sending an email request for review. Email response time is currently up to 5 business days.

*Your First Name:
*Your Last Name:
*Your Phone Number:  ext
 
* Your Email Address:
* Re-enter Your Email Address:
 
You must enter a valid email address to receive a response.

Your Address
Address:
City:
State:
ZIP:
*Response Method:

Subscriber and Patient Information
I only have a check from BCBSNE and need patient claim information:
Federal Employee:
Check this box if the patient's identification number starts only with an R, followed by eight numbers (example: R01234567)
*Prefix/ID Number: -

The patient's Blue Cross and Blue Shield of Nebraska identification number (including the prefix) is located on the front of their ID card.
 

*Subscriber First Name:
*Subscriber Last Name:


Person Complaint is About
*First Name:
*Last Name:
Address:
City:
State:
ZIP:
Phone Number:  ext 
Incident Date:
*Summary of Complaint:

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Blue Cross and Blue Shield of Nebraska is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield Association licenses Blue Cross and Blue Shield of Nebraska to offer certain products and services under the Blue Cross® and Blue Shield® brand names within the state of Nebraska.