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Availity^® Essentials Register with Availity Essentials to verify eligibility and benefits, submit benefit prior authorization requests handled by BCBSIL,* obtain claim status, view provider claim summaries and more. You can also use BlueApprovR^SM*.	Availity Provider Portal Availity Client Services – 800-282-4548
Behavioral Health Program BCBSIL manages BH services for all commercial non-HMO members who have BH benefits through group/retail products. Similar BH programs are implemented across product lines but may differ by product.	Behavioral Health Contact Information
BlueCard Eligibility^® Line Call for out-of-state Blue Cross and Blue Shield member eligibility and benefits	800-676-2583
Carelon Medical Benefits Management For commercial non-HMO prior authorization requests handled by Carelon.	Carelon Provider Portal Carelon Contact Center – 866-455-8415 (Monday through Friday, 6 a.m. to 6 p.m., CT; and 9 a.m. to noon, CT on weekends and holidays)
Electronic Commerce Services Contact us if you have questions about electronic transactions that cannot be answered by your clearinghouse or software vendor. Refer to our Electronic Commerce page for more information.	Email our Electronic Commerce Services team.
eviCore healthcare (eviCore) For government programs (Medicare Advantage and Illinois Medicaid) prior authorization requests handled by eviCore.	eviCore Web Portal eviCore toll-free – 855-252-1117 (Monday through Friday, 7 a.m. to 7 p.m., CT, except holidays)
Federal Employee Program^® (FEP^®) Verify eligibility and benefits and/or check claim status for FEP members	800-972-8382
Fee Schedule Requests For providers who are already participating in our Preferred Provider Option (PPO), Blue Choice PPO^SM, Blue Choice Preferred^SM, Blue Choice Select^SM, and Blue High Performance Network® (BlueHPN®) networks.	Refer to our Fee Schedule page for forms and instructions.
Fraud Hotline Report concerns of potential fraud 24/7 to our Special Investigations Department (SID).	File a report online, or Call the Fraud Hotline at 800-543-0867. All inquiries are confidential, and you may remain anonymous.
Medical Management If you have questions on a prior authorization request handled by BCBSIL, use our automated phone system to contact our Medical Management department.	Commercial (non-HMO) – 800-572-3089 Government Programs – 877-774-8592 (MA PPO); 877-860-2837 (BCCHP); 877-723-7702 (MMAI)
Pharmacy Programs BCBSIL uses Prime Therapeutics LLC as our pharmacy benefit manager to administer our pharmacy program for eligible members.	Refer to our Pharmacy Programs section for details.
Provider Customer Service –Commercial If you don’t have online access, call our Provider Telecommunications Center to use our automated phone system for eligibility and benefits, other self-service requests and claims inquiries.	800-972-8088 (Monday – Friday, 8 a.m. to 11:30 p.m. CT; Saturday – 6 a.m. to 3:30 p.m. CT; Sunday – Closed)
Provider Customer Service – Government Programs Use these numbers for claims and other inquiries for Blue Cross Community Health Plans^SM (BCCHP^SM), Blue Cross Community MMAI (Medicare-Medicaid Plan)^SMand Blue Cross Medicare Advantage^SM (HMO and PPO).	BCCHP – 877-860-2837 MMAI – 877-723-7702 Medicare Advantage – 877-774-8592
Provider Demographic Updates If you need to change your existing demographic information [legal name; National Provider Identifier (NPI)/Tax ID; physical address(s), phone/fax number, email, hours of operation, etc.]:	See our Verify and Update Your Information page for instructions. Complete our online Demographic Change Form.
Provider Learning Opportunities Free training is available for providers, billing services, clinical and administrative staff who are new or already participating in the BCBSIL network.	To register, visit the Webinars and Workshops page. For customized training, contact our Provider Education Consultant Specialist team.
Provider Network Consultants (PNCs) Our PNCs can offer information on how to use online tools, BCBSIL products and initiatives, provider education opportunities and personalized office visits.	View Provider Network Consultant Assignments.
Provider Roster Requests To request a roster for your practice, include your group name, NPI and Tax ID.	Email our Provider Roster Requests team.

Availity^® Essentials

Register with Availity Essentials to verify eligibility and benefits, submit benefit prior authorization requests handled by BCBSIL,* obtain claim status, view provider claim summaries and more.

*You can also use BlueApprovR^SM.

Availity Provider Portal
Availity Client Services – 800-282-4548

Behavioral Health Program

BCBSIL manages BH services for all commercial non-HMO members who have BH benefits through group/retail products. Similar BH programs are implemented across product lines but may differ by product.

Behavioral Health Contact Information

BlueCard Eligibility^® Line

Call for out-of-state Blue Cross and Blue Shield member eligibility and benefits

800-676-2583

Carelon Medical Benefits Management

For commercial non-HMO prior authorization requests handled by Carelon.

Carelon Provider Portal

Carelon Contact Center – 866-455-8415 (Monday through Friday, 6 a.m. to 6 p.m., CT; and 9 a.m. to noon, CT on weekends and holidays)

Electronic Commerce Services

Contact us if you have questions about electronic transactions that cannot be answered by your clearinghouse or software vendor. Refer to our Electronic Commerce page for more information.

Email our Electronic Commerce Services team.

eviCore healthcare (eviCore)

For government programs (Medicare Advantage and Illinois Medicaid) prior authorization requests handled by eviCore.

eviCore Web Portal

eviCore toll-free – 855-252-1117 (Monday through Friday, 7 a.m. to 7 p.m., CT, except holidays)

Federal Employee Program^® (FEP^®)

Verify eligibility and benefits and/or check claim status for FEP members

800-972-8382

Fee Schedule Requests

For providers who are already participating in our Preferred Provider Option (PPO), Blue Choice PPO^SM, Blue Choice Preferred^SM, Blue Choice Select^SM, and Blue High Performance Network® (BlueHPN®) networks.

Refer to our Fee Schedule page for forms and instructions.

Fraud Hotline

Report concerns of potential fraud 24/7 to our Special Investigations Department (SID).

File a report online, or

Call the Fraud Hotline at 800-543-0867.

All inquiries are confidential, and you may remain anonymous.

Medical Management

If you have questions on a prior authorization request handled by BCBSIL, use our automated phone system to contact our Medical Management department.

Commercial (non-HMO) – 800-572-3089

Government Programs – 877-774-8592 (MA PPO); 877-860-2837 (BCCHP); 877-723-7702 (MMAI)

Pharmacy Programs

BCBSIL uses Prime Therapeutics LLC as our pharmacy benefit manager to administer our pharmacy program for eligible members.

Refer to our Pharmacy Programs section for details.

Provider Customer Service –Commercial

If you don’t have online access, call our Provider Telecommunications Center to use our automated phone system for eligibility and benefits, other self-service requests and claims inquiries.

800-972-8088 (Monday – Friday, 8 a.m. to 11:30 p.m. CT; Saturday – 6 a.m. to 3:30 p.m. CT; Sunday – Closed)

Provider Customer Service – Government Programs

Use these numbers for claims and other inquiries for Blue Cross Community Health Plans^SM (BCCHP^SM), Blue Cross Community MMAI (Medicare-Medicaid Plan)^SMand Blue Cross Medicare Advantage^SM (HMO and PPO).

BCCHP – 877-860-2837

MMAI – 877-723-7702

Medicare Advantage – 877-774-8592

Provider Demographic Updates

If you need to change your existing demographic information [legal name; National Provider Identifier (NPI)/Tax ID; physical address(s), phone/fax number, email, hours of operation, etc.]:

See our Verify and Update Your Information page for instructions.

Complete our online Demographic Change Form.

Provider Learning Opportunities

Free training is available for providers, billing services, clinical and administrative staff who are new or already participating in the BCBSIL network.

To register, visit the Webinars and Workshops page.

For customized training, contact our Provider Education Consultant Specialist team.

Provider Network Consultants (PNCs)

Our PNCs can offer information on how to use online tools, BCBSIL products and initiatives, provider education opportunities and personalized office visits.

View Provider Network Consultant Assignments.

Provider Roster Requests

To request a roster for your practice, include your group name, NPI and Tax ID.

Email our Provider Roster Requests team.

Checking eligibility and/or benefit information and/or obtaining prior authorization is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage, including, but not limited to, exclusions and limitations applicable on the date services were rendered. Certain employer groups may require prior authorization or pre-notification through other vendors. If you have any questions, call the number on the member's ID card. Regardless of any prior authorization or benefit determination, the final decision regarding any treatment or service is between the patient and the health care provider.

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. Carelon Medical Benefits Management is an independent company that has contracted with BCBSIL to provide utilization management services for members with coverage through BCBSIL. BCBSIL makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.

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