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Internal Grievance

Under the standard internal grievance process, we must provide you with our final written determination within 35 calendar days of our receipt of your written grievance. However, that timeframe may be suspended for any amount of time that you are permitted to take to file your grievance, and for a period of up to 10 days if we have not received information we have requested from a health care provider, such as your doctor or hospital.


The standard internal grievance process is as follows:

  1. You or your authorized representative must send us a written statement explaining why you disagree with our determination on your request for benefits or payment.
  2. Mail your written grievance to the address located in the top right hand corner of the first page of your Explanation of Benefits statement, or to the address contained in the letter we send you to notify you that we have not approved a benefit or service you are requesting.
  3. We will respond to your grievance in writing. If you agree with our response, it becomes our final determination and the grievance ends. If you disagree with our response, you may request a managerial-level conference. You must request the conference in writing.

    Mail your request to:

    Conference Coordination Unit
    Blue Cross Blue Shield of Michigan
    PO Box 2459
    Detroit, MI 48231-2459

    You can ask that the conference be conducted in person or over the telephone. If in person, the conference can be held at our headquarters in Detroit or at a local customer service center. Our written resolution will be our final determination regarding your grievance.
  4. If you disagree with our final determination, or if we fail to provide it to you within 35 days of the date we received your original written grievance, you may request an external review from the Michigan Commissioner of Financial and Insurance Services.

You Should Also Know

  • You may authorize in writing another person, including, but not limited to, a physician, to act on your behalf at any stage in the standard internal grievance procedure.
  • Although we have 35 days to give you our final determination, you have the right to allow us additional time if you wish.
  • You may obtain copies of information relating to our denial, reduction, or termination of coverage for a health care service for a reasonable copying charge.