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Government Programs: New Claim Status Tool via Availity® Provider Portal

Posted November 5, 2019

This notice applies to providers rendering services for the following Blue Cross and Blue Shield of Illinois (BCBSIL) government programs members:

  • Blue Cross Community Health PlansSM and Blue Cross Community MMAI (Medicare-Medicaid Plan)SM
  • Blue Cross Medicare Advantage (HMO)SM and Blue Cross Medicare Advantage (PPO)SM

As of Oct. 31, 2019, a new and improved Availity Claim Status tool is available for you to check status online for claims submitted to BCBSIL for the above-referenced members. Registered Availity users may access the Claim Status tool via the Claims & Payment menu in the Availity portal. This tool allows you to search for claims by member ID or specific claim number.

Availity Claim Status results are returned in real-time, with more detailed information than the Health Insurance Portability and Accountability Act of 1996 (HIPAA) standard 277 claim status transaction. This new claim status option provides you with the following details:

  • Patient and provider data submitted on claims
  • In-network and out-of-network patient liability breakdown
  • Billing and rendering provider name and National Provider Identifier (NPI)
  • Check number, check date and payee name
  • Other carrier payment amount
  • Ineligible reason codes and associated descriptions

Sign Up for a November Webinar

We encourage you to register for an online training session to learn how to efficiently check status for government programs claims using this new online capability. To register for a session, simply click on your preferred date and time below.

For More Information

Watch for a new Government Programs: Claim Status Tool tip sheet, coming soon to the Provider Tools section of our website. As a reminder, you must be registered with Availity to use the Claim Status tool. For registration information, visit availity.com, or contact Availity Client Services at 800-282-4548.

Questions? Contact our Provider Education Consultants at PECS@bcbsil.com.

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.