Network Termination Appeal

Policy Number: GP-X-066

Last Updated: Sept. 12, 2022 

Blue Cross and Blue Shield of Nebraska (BCBSNE) offers providers an appeal and fair hearing process. This process is to be used in instances when BCBSNE makes the decision to decline participation in plan networks, places a provider in a non-payable status or terminates a provider's participation for cause based on quality issues, utilization issues, FWA (fraud, waste, or abuse), or non-compliance with credentialing criteria or contractual and policy requirements, except as identified in the Non-Appealable Decisions policy