CommercialAdministrativeMedium impact
PAP236 - Inquiry and Appeals Process - Revised for updated process and contracts.
Blue Cross of Idaho·ID·Medical Policy
Effective date
May 1, 2026
We identified it
Jun 19, 2026
Summary
Blue Cross of Idaho has revised their PAP236 inquiry and appeals process policy with updated procedures and contracts. The policy outlines specific timeframes and processes for pre-service reconsiderations, peer-to-peer calls, and post-service claim inquiries and appeals for providers.
Action Required
Before May 1, 2026: Billing teams must update workflows to comply with new inquiry and appeals processes. For pre-service denials, submit peer-to-peer requests to Peer2PeerRequests@bcidaho.com within 5 business days. Submit written reconsideration requests within 15 business days (3 days for expedited). Use the provider portal at providers.bcidaho.com for post-service claim inquiries. Train staff on new fax numbers for different service types and ensure proper documentation is included with all requests.