Blue Cross & Blue Shield of Rhode Island (BCBSRI) has selected MES Solutions, Inc. (MES) as our Billing Dispute External Review Agency to resolve disputes with eligible physicians or physician groups arising from covered services concerning BCBSRI’s application of coding and payment rules and methodologies to fee-for-service claims.

Please note: Medicare Advantage, BlueCHiP for RIteCare, and Federal Employees Program claims are not eligible for this process.

If you disagree with our internal decision on a case and would like further review, please submit your billing dispute to MES within ninety (90) days of receiving our denial notice. A Referral Form must be completed for each member and each date of service in dispute. You may use the MES Billing Dispute Resolution Web site to complete the required Referral Form online. The Love Settlement Agreement requires that physicians or physician groups submit a filing fee with the billing dispute. In addition, the Web site calculates your filing fee and allows you to pay this fee securely online.

Disputes for Amounts Less than $500
A physician or physician group may submit a billing dispute for an amount less than $500 if they intend to submit similar billing disputes within one (1) year that add up to more than $500. MES will defer consideration of these disputes until the total amount in question exceeds $500. In the event that additional, similar billing disputes are not submitted within one (1) year of the original billing dispute, or the amounts in dispute do not exceed $500, MES will dismiss the original and any such additional billing disputes.

If you have a question regarding a billing dispute you sent to MES, please contact MES at 1-800-437-8583.

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