We want you to be satisfied with your care. If you have a complaint about any service or care you received from BCBSTX or a provider, we want you to tell us if you are not satisfied. If you are a CHIP member and you have a complaint, call BCBSTX customer service toll-free at 1-888-657-6061 (TTY 7-1-1) to get help. CHIP members will be asked to fill out a complaint form . You can download the form online. After you fill it out, mail it to:
Attn: Complaint Coordinator
Blue Cross and Blue Shield of Texas (BCBSTX)
P.O. Box 27838
Albuquerque, NM 87125-7838
You can also call the customer service line and we will send you the form to fill it out and mail it to the address on the form.
BCBSTX also have a bilingual Member Advocate that can help you file your complaint. You can reach the member advocate at 1-877-375-9097. If you do not speak English, customer service or our member advocate will get a translator to help you file your complaint. If you are not satisfied with how BCBSTX resolved your complaint, you can file a complaint with The Health and Human Services Commission (HHSC) by calling toll-free 1-866-566-8989 or by e-mailing HPM_Complaints@hhsc.state.tx.us.
When you file an appeal, BCBSTX will take another look at your case to see if there is something else we can do to solve your problem. You may use the appeal request form or call Customer Service at 1-888-657-6061 (TTY 7-1-1).
Blue Cross and Blue Shield of Texas
c/o Complaints and Appeals Department
P. O. Box 27838
Albuquerque, NM 87125-7838
BCBSTX will send you a letter within five working days after we get your form to let you know we received your appeal request. You will get an answer within 30 days from when you asked for the appeal.
If you are not happy with the BCBSTX decision on your appeal, you can ask for an Independent Review through the Texas Department of Insurance (TDI). You can only file for a review after you go through the entire BCBSTX appeals process. You may call 1-800-252-3439 or write to:
Texas Department of Insurance
HMO Quality Assurance Section
Mail Code 103-6A
PO Box 149104
Austin, TX 78714-910
We can help you file your request for an appeal. Your health-care provider, a friend, a relative, legal, or spokesperson can also stand for you and ask for an appeal.
If you have questions about filing a complaint or appeal, please call Customer Service at 1-888-657-6061 (TTY 7-1-1). You may also call to check on the status of an existing request.
For more information regarding Complaints and Appeals, please see Your Rights for an Appeal of an Adverse Determination and the Complaints and Appeals section of your Member Handbook .