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Claim Status and Adjudication

After submitting a claim, you can check the status online. In doing so, you can verify if your claim has been received, pended or finalized. Additionally, you can verify the descriptions for any claim denials. 

For example, for commercial claims, you or your billing agent can obtain real-time results by checking claim status through the Availity® Claim Research Tool. The Claim Research Tool provides the equivalent of an Explanation of Benefits (EOB), including line item breakdowns and detailed denial descriptions. All results are printable and can be used as a duplicate EOB for another insurance carrier when requested.

If you have questions or need to request a claim adjustment, a document control number (claim number) is required when calling our Interactive Voice Response (IVR) automated phone system to speak with an agent. To access our IVR system, call 800-972-8088. The system is available Monday through Friday, 6 a.m. to 11:30 p.m., CT, and Saturday, 6 a.m. to 6 p.m., CT. For additional details, refer to the Claims Caller Guide.

For government programs claims, check claim status online by submitting a Claim Status Inquiry via the Availity Provider Portal , or submit an electronic claim status request (276 transaction) via your preferred vendor portal. If you do not have online access, call provider customer service to check claim status or make an adjustment:

Blue Cross Community Health PlansSM (BCCHP) – 877-860-2837

Blue Cross Community MMAI (Medicare-Medicaid Plan)SM – 877-723-7702

Blue Cross Medicare AdvantageSM – 877-774-8592

Note: If your claim did not process the way you anticipated, it is important that you do not submit a duplicate claim for the same patient. Duplicate claims typically result in additional denials.

Questions?

Email our Provider Education Consultants. Be sure to include your name, direct contact information, tax ID or billing NPI. 

Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSIL. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Availity. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.