Appeals for Patients with Commercial Insurance

Beth Israel Deaconess Care Organization (BIDCO) is a provider organization that is certified as a “risk-bearing provider organization” (RBPO) by the Massachusetts Division of Insurance.  An RBPO is a group of health care providers that work together to coordinate patient care and enter into financial agreements with insurance companies to do so, thereby sharing financial risk.

Under Massachusetts law, patients with commercial insurance whose primary care provider, also commonly called a PCP, participates in an RBPO have the right to make an appeal and use an appeals process to resolve an issue. BIDCO considers patient appeals such as:

  • Referral restrictions
  • Type or intensity of treatment or services
  • Timely access to treatment or services
  • Other concerns about limitations of care

Appeals or complaints about insurance coverage issues should continue to be managed by your health insurer. 

You can contact BIDCO to discuss the appeals process or to file an appeal. You can also choose a person (such as a spouse, family member, friend, attorney or legal guardian) to act as your representative to help you with your appeal.

There are two ways to file an appeal:

  • To file an appeal by phone:                         (617) 754-1000, Option “5”          
  • To file an appeal in writing:                        Use this link

BIDCO will give you a written answer to your appeal within fourteen (14) days.  If your appeal involves urgent medical needs, BIDCO will give you a written answer within three (3) days.

Do you have questions or need more information?

  • For more information or questions on how to file an appeal, please call (617) 754-1000, Option “5”. 
  • For more information on your right to file an appeal, please contact the Massachusetts Office of Patient Protection at (800) 436-7757.
  • For more information or questions on the RBPO Appeals Process, please contact us at bidcoadministration@bidco.org or 617-754-1000.