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BLUECONNECT
Providers
March 2025
In This Issue
► March News: Executive Summary
► Coming soon: AZ Blue to adopt MCG 29th edition
► Send all disputes for CHS claims to the group's TPA
► Dental benefits for Medicare Advantage members
► Include these data elements for quick responses
Send all disputes for CHS claims to the group's TPA
We give Corporate Health Services (CHS) group plans access to the AZ Blue PPO network through a rental arrangement. These groups use a third-party administrator (TPA) to manage their benefit plans. If you participate in our broad PPO network, you are in-network for all of our CHS group members.
The group’s TPA is your primary contact
The group’s TPA handles almost everything for CHS plans. AZ Blue only provides access to the network and prices the claims. So you do need to send us your claims (including claim adjustments). But once we price them, that’s it. We immediately forward them to the TPA. The TPA takes it from there to process and pay your claims. On the remit, you will see information about where to send appeals and grievances.
Important: For CHS group members, please direct all appeals and grievances to the group’s TPA at the address listed on the remittance advice. The TPAs also handle disputes related to claims for out-of-network services in scope for the No Surprises Act (NSA) negotiation/arbitration process. Please note that if you are contracted with the AZ Blue PPO network, you are not eligible for the NSA process.
More about CHS appeals and grievances
The TPA reviews and processes appeal and grievance requests. Occasionally, the TPA may ask AZ Blue to review an appeal for a possible pricing adjustment. If so, the TPA will forward the information to us. We review the appeal and respond to the TPA. When appropriate, we send the TPA a repriced claim. The TPA will inform you of the determination or send you an updated remit.
CHS plan coverage outside of Arizona
Our CHS groups rent the AZ Blue Statewide PPO network only (not the national Blue Cross Blue Shield network). They may have arrangements with another payer for network coverage outside of Arizona.
For more information about who does what for CHS plans, check out our CHS Group Plans—Excerpt from the 2025 Provider Operating Guide.
In This Issue
► March News: Executive Summary
► Coming soon: AZ Blue to adopt MCG 29th edition
► Send all disputes for CHS claims to the group's TPA
► Dental benefits for Medicare Advantage members
► Include these data elements for quick responses

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