Regence BlueCross BlueShield of Oregon denied your claim. Here is your deadline.
Put in the date on your Regence BlueCross BlueShield of Oregon notice and get both federal deadlines as calendar dates.
Free, for a Regence BlueCross BlueShield of Oregon denial in Oregon, and it runs entirely in your browser. The date, the plan type and the state you pick are never sent to us and never stored.
Regence BlueCross BlueShield of Oregon denied 100,498 of 1,013,376 in-network claims in Oregon; every one of those denials had these same two dates on it. Across Oregon as a whole the insurers in this file denied 10.9% of in-network claims, 277,498 of them, and 1,265 were appealed.
Regence BlueCross BlueShield of Oregon denied 9.9% of in-network claims in Oregon, 100,498 claims out of 1,013,376.
Insurance got denied, what to do next?
Those 100,498 denials are 36.2% of every in-network denial recorded in Oregon in this release, which makes Regence BlueCross BlueShield of Oregon the 2nd largest source of denials of the 6 insurers reporting there. Spread across its 14 plans in the state that is about 7,178 denials per plan. 616 internal appeals were filed against those 100,498 denials. Every one of those denials carried the same two dates the tool at the top of this page works out.
Two dates matter more than anything else on this page, and they run the same in Oregon as everywhere else. You have 180 days from the date on your denial notice to file the internal appeal, and then 4 months from the final internal denial to ask for an independent external review. If waiting would seriously jeopardize your health you can ask for both to be expedited, decided in about 72 hours. Both timeframes are federal, not your insurer's choice, 29 CFR 2560.503-1 (PDF) and 45 CFR 147.136 (PDF), in plain English at HealthCare.gov, and your own denial letter states the ones that govern your plan. The PDFs are the same sections on govinfo.gov, which serves them without a challenge page, so an automated reader can check these two dates as easily as you can.
You are not alone, and here is the measured version of that sentence: 100,498 in-network claims were denied by Regence BlueCross BlueShield of Oregon in Oregon in a single plan year. A denial rate is a fact about an insurer's book of business. It is not a judgment about you, and it is not the last word on your claim.
- Of the 6 insurers reporting a denial rate in Oregon, Regence BlueCross BlueShield of Oregon is the fourth highest at 9.9%. The highest in the state is 17.4% and the lowest is 4%.
- That is 8.8 percentage points below the 18.7% national average across this dataset, and 1 points below the Oregon average of 10.9%.
- Behind the percentage: 1,013,376 in-network claims were processed under 14 plans in Oregon, and 100,498 of them came back denied.
- For every 10,000 claims Regence BlueCross BlueShield of Oregon denied, about 61 came back as an internal appeal. The other 9,939 stopped at the letter.
- Of the internal appeals it did receive, Regence BlueCross BlueShield of Oregon overturned 14.29%, 88 claims that started life as a no.
- 47 of those denials went on to independent external review, the stage whose decision the plan is required by law to accept. Nationally 32.8% of external reviews are overturned.
- Its most-recorded denial reason is other reasons at 89.4% of its categorized denials, against 32.3% nationally, a heavier share than the country as a whole. That is the denial mix, not an outcome rate.
- Regence BlueCross BlueShield of Oregon accounts for 36.2% of every in-network claim denied in Oregon in this file.
- By raw volume it is the 98th largest source of denials among the 158 insurer-state records in the file that report one.
- Put another way: one independent external review was filed for every 2,138 claims Regence BlueCross BlueShield of Oregon denied in Oregon.
- After that, its second-most-recorded reason is service excluded from the plan, 11,073 claims, 7.8% of its categorized denials.
- Third on its own list is referral required, 2,153 claims, 1.5% of what Regence BlueCross BlueShield of Oregon categorized in Oregon. Between them the top three account for 98.7% of its categorized denials.
- Where Regence BlueCross BlueShield of Oregon differs most from the national mix is other reasons: 89.4% of its categorized denials in Oregon against 32.3% across the file.
- Read the other way round: 912,878 of those 1,013,376 in-network claims were paid, 90.1% of everything Regence BlueCross BlueShield of Oregon processed in Oregon.
- Spread across the 14 plans it reports in Oregon, that is about 7,178 denied claims per plan, on about 72,384 claims processed per plan.
- Its reason columns add up to 141,660 categorized rows against 100,498 denials, 141% of them, and every reason share on this page is a share of that first figure rather than of the second.
- Its smallest recorded category in Oregon is benefit limit reached, 44 claims, 0% of what Regence BlueCross BlueShield of Oregon categorized there.
- Against the file as a whole, this one record is 0.1% of the 84,502,749 in-network claim denials reported by every issuer in it.
- Find the reason code on your denial letter. The reason Regence BlueCross BlueShield of Oregon records most often in Oregon is other reasons, but yours may be one of the other 8, copy the exact wording and code off your own letter tonight, because that sentence is what your appeal has to answer.
- Ask Regence BlueCross BlueShield of Oregon in Oregon for the clinical criteria they judged you against. Under 29 CFR 2560.503-1 they have to hand you the claim file and the policy they applied, free, on request, and you cannot argue with a checklist you have never read.
- Put both deadlines on your calendar before you go to bed. 180 days from the date on the letter for the internal appeal, 4 months from the final internal denial for external review. The free calculator on this page turns your date into the two calendar dates in about ten seconds. Regence BlueCross BlueShield of Oregon overturned 14.29% of the internal appeals it did receive, 88 claims, so the stage you are about to start is not decorative.
None of those three steps costs anything. Anyone charging you to do them is selling you something you can do yourself in twenty minutes.
How that compares
| Denial rate | Rate | Difference |
|---|---|---|
| Regence BlueCross BlueShield of Oregon | 9.9% | , |
| Oregon average | 10.9% | -1 pts |
| National average (this dataset) | 18.7% | -8.8 pts |
Regence BlueCross BlueShield of Oregon sits at or below the national average across this dataset. A denial rate is a property of the insurer's book of business, coding practice, plan design, the population it covers, not evidence about the merits of any one claim, including yours.
What happened to appeals
| Stage | Filed | Overturned |
|---|---|---|
| Internal appeal (to Regence BlueCross BlueShield of Oregon) | 616 | 14.29% |
| External review (independent) | 47 | not reported |
The gap nobody escalated
100,498 claims denied. 616 internal appeals filed. 47 reached independent external review. Nationally 32.8% of external reviews are overturned and the decision binds the plan.
That is arithmetic from the reported figures, not a prediction: nobody can say what those specific denials would have done at review, because they never got there. What the numbers do establish is that the binding stage was almost entirely unused here.
What that record means for your own Regence BlueCross BlueShield of Oregon letter, and by when. Regence BlueCross BlueShield of Oregon overturned 14.29% of the 616 internal appeals its Oregon members filed against 100,498 denials, and 47 of those Oregon denials went on to the independent stage whose decision binds the plan, Regence BlueCross BlueShield of Oregon's own rows in the plan-year 2026 release of the CMS Transparency in Coverage file, read September 5, 2026 (data.healthcare.gov). Whichever way that lands, nobody files the appeal for you, and the filing runs on a clock set by which plan you hold: an employer or Marketplace plan gives you at least 180 days from the denial notice to file the internal appeal (29 CFR 2560.503-1(h)(3)(i), carried onto individual-market coverage by 45 CFR 147.136(b)(3)(i)), while Medicare Advantage gives you 60 calendar days after you receive its notice (42 CFR 422.582(b)) and Medicaid managed care the same 60 calendar days from the date on the notice (42 CFR 438.402(c)(2)(ii)), both stages free, and the three steps above are the whole of what to do tonight, so take the date printed on your Regence BlueCross BlueShield of Oregon notice and file well inside whichever of those windows is yours. The free steps are above; the $29 kit is the same clock with the letters pre-filled for Regence BlueCross BlueShield of Oregon in Oregon. One payment. No subscription. No cut of your claim.
Regence BlueCross BlueShield of Oregon inside Oregon
Your denial did not happen in a national average. It happened in a state market, alongside 5 other insurers reporting into the same federal file, and these are that market's own figures.
- Across the whole of Oregon, the 6 insurers reporting in this file processed 2,552,164 in-network claims and denied 277,498 of them, a state denial rate of 10.9%. Regence BlueCross BlueShield of Oregon is one of those 6.
- That puts Oregon 27th of 30 states by denial rate, 7.8 points below the 18.7% national average, before you get to what Regence BlueCross BlueShield of Oregon did inside it.
- Oregon recorded 1,265 internal appeals against those denials: one appeal for every 219 claims the state's insurers refused. Regence BlueCross BlueShield of Oregon's own ratio is one for every 163.
- Independent external review was reached 47 times in the whole of Oregon, once for every 5,904 denials, against one in 14,369 nationally. 47 of those Oregon filings came from Regence BlueCross BlueShield of Oregon's denials.
- Of the Oregon external reviews that were filed, 0 were overturned, 0%. That percentage is measured on 47 reviews, which is why the count beside it matters more than the rate does when you are deciding whether to file against Regence BlueCross BlueShield of Oregon.
- The reason Oregon's insurers record most often is other reasons, 139,261 claims, 84% of the state's categorized denials. Regence BlueCross BlueShield of Oregon records the same one most often, so your letter is likely to say it too.
- The other insurers an Oregon reader could have bought from run from 17.4% (PacificSource Health Plans) to 4% (Providence Health Plan). Regence BlueCross BlueShield of Oregon at 9.9% sits between the two.
- Put the two together and Regence BlueCross BlueShield of Oregon is responsible for 36.2% of every in-network claim denied in Oregon in this release, from 39.7% of the claims the state's insurers processed.
- Every Oregon figure in this section is that state's own row in the same federal file Regence BlueCross BlueShield of Oregon's numbers above come from, CMS Transparency in Coverage Public Use File (PY2026 release, PY2024 claims), data.healthcare.gov — US Government public domain, and the full Oregon page is free at /states/oregon.
What Regence BlueCross BlueShield of Oregon denies most
The most common denial reason recorded for Regence BlueCross BlueShield of Oregon plans in Oregon is other reasons. How that denial is beaten →
| Denial reason | Claims | Share | National share |
|---|---|---|---|
| Other reasons | 126,617 | 89.4% | 32.3% |
| Service excluded from the plan | 11,073 | 7.8% | 11.6% |
| Referral required | 2,153 | 1.5% | 8.4% |
| Administrative reason | 1,374 | 1% | 22.5% |
| Not medically necessary | 352 | 0.2% | 4.6% |
| Experimental or investigational | 47 | 0% | 0.1% |
| Benefit limit reached | 44 | 0% | 4.2% |
The last column is each reason's share of all categorized denials nationally, so you can see where Regence BlueCross BlueShield of Oregon's mix in Oregon differs from everyone else's. This is denial mix, not overturn rate by reason, the federal file does not report appeal outcomes broken down by denial reason, and we do not imply otherwise.
Put the date from your notice in and get the two calendar dates, with the days remaining.
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The three steps at the top of this page are the whole of what you have to do tonight. The longer version, what the internal appeal has to contain, how the independent stage works, and how to ask for expedited handling when waiting would seriously jeopardize your health, is published free here. For what it is worth on this page specifically: Regence BlueCross BlueShield of Oregon overturned 14.29% of the internal appeals it received.
Questions
Is Regence BlueCross BlueShield of Oregon's denial rate in Oregon high?
9.9% against a national average of 18.7% across the plans in this dataset. It is at or below average. A denial rate describes the insurer, not the merits of your claim.
How many people appealed a Regence BlueCross BlueShield of Oregon denial in Oregon, and how many won?
616 internal appeals were filed against 100,498 denials, and 14.29% of them were overturned (88 claims). 47 went on to independent external review.
How does Regence BlueCross BlueShield of Oregon compare with other insurers in Oregon?
Of the 6 insurers in Oregon with a reported denial rate, Regence BlueCross BlueShield of Oregon ranks 4 highest at 9.9%. The highest in Oregon is PacificSource Health Plans at 17.4%; the lowest is Providence Health Plan at 4%.
What does Regence BlueCross BlueShield of Oregon deny most often in Oregon?
Other reasons, 126,617 claims, 89.4% of this issuer's categorized denials, against 32.3% nationally. This is the denial-reason mix; the federal file does not report overturn rates by reason.
How long do I have to appeal a Regence BlueCross BlueShield of Oregon denial in Oregon?
Generally 180 days from the date on the denial notice to file the internal appeal, then generally four months from the final internal denial to request independent external review. Expedited review, decided in about 72 hours, is available where delay would seriously jeopardize your health. Those timeframes are federal, so they are identical for every insurer reporting in Oregon, Regence BlueCross BlueShield of Oregon included, what varies by state is who runs the independent review at the end. Your own denial letter states the deadlines that govern your plan; that letter is the authority.
Does appealing a Regence BlueCross BlueShield of Oregon denial in Oregon cost anything?
The internal appeal to Regence BlueCross BlueShield of Oregon is free. External review is free under the HHS-administered federal process; where an issuer uses a contracted independent review organization or a state process, any fee is capped at $25 per review. Nobody in Oregon can be charged more than that to file one.
Can Regence BlueCross BlueShield of Oregon ignore an external review decision in Oregon?
No, and that is the whole point of the stage. External review decisions are binding on the plan by law, which is what makes the 47 external reviews recorded against 100,498 Regence BlueCross BlueShield of Oregon denials in Oregon the striking number on this page.
Regence BlueCross BlueShield of Oregon sits at 9.9% in Oregon against 18.7% nationally, and that is the whole of what this page can honestly tell you about your own claim. I am not going to tell you that you will win. This page prints the insurer's own reported numbers whichever way they fall. If what it says does not match the letter in your hand, write to me and I will correct the page.
, Andrew at Axion Labs · hello@getaxionlabs.comEverything you need for your Regence BlueCross BlueShield of Oregon appeal in Oregon: your two deadlines, the argument that fits your denial reason, the letters, the clinician brief, and the external review request. One payment. No subscription. No cut of your claim. Opens on screen the moment you pay. 14-day refund, no questions, one email to hello@getaxionlabs.com.
The Regence BlueCross BlueShield of Oregon figures on this page, the 9.9% denial rate, the 100,498 denials and the 47 external reviews, are this issuer’s own reported rows in that file.
Counts: CMS Transparency in Coverage Public Use File (PY2026 release, PY2024 claims), data.healthcare.gov — US Government public domain. Rights and timeframes: 29 CFR 2560.503-1 (180 days, and your free right to the claim file) and 45 CFR 147.136 (4 months, and what qualifies), explained at HealthCare.gov. Expedited review is decided in about 72 hours under both sections.
Reading either regulation from a script rather than a browser: eCFR answers automated fetches with a challenge page, so the same two sections are mirrored as government PDFs at govinfo.gov (29 CFR 2560.503-1) and govinfo.gov (45 CFR 147.136).