Blue Shield of California's published appeal, dispute, and timely-filing windows are below, each quoted verbatim from Blue Shield of California's provider documentation or the governing regulation with a source link. Which window applies can depend on the product and its regulator, so confirm the product before you calendar the deadline.
Day types are not interchangeable: calendar, business, and month windows each count differently, and month windows are never converted to days. Every value below is quoted from its primary source.
Deadlines you must hit
Provider dispute filing
365 calendar daysClock starts: date of plan action or inaction
Must give provider at least 365 days to submit an appeal.
Source: BSCA AB 1455 Provider Claims & Dispute Resolution Summary, p. 5
Payer response clocks
Provider dispute acknowledge electronic
2 business daysClock starts: date of receipt
Must acknowledge receipt of a provider appeal: within 2 business days for appeals submitted electronically and within 15 working days for appeals submitted in paper form.
Source: BSCA AB 1455 Summary, p. 5
Provider dispute acknowledge paper
15 working daysClock starts: date of receipt
...within 15 working days for appeals submitted in paper form.
Source: BSCA AB 1455 Summary, p. 5
Provider dispute resolution
45 working daysClock starts: date of receipt of dispute
Must resolve appeals in accordance with claims timeliness requirements (30/45 working days) and must send written determination on the appeal within 45 working days.
Source: BSCA AB 1455 Summary, p. 5
MA member grievance resolution
30 calendar daysClock starts: receipt of grievance
The complaint will be resolved within 30 calendar days of receipt.
Source: BSCA Independent Physician and Provider (IPP) Manual, July 2026 edition, p. 29
MA post service claim appeal resolution
60 calendar daysClock starts: receipt of appeal
Post-service appeals (claims) are resolved within 60 days.
Reference information for provider billing teams, not legal advice. Windows depend on the plan's regulator and product, so confirm against your contracted provider manual. Sources retrieved 2026-07-04.