Enhanced Availity® Claim Status Tool Replaces Claim Research Tool, Gives You One Tool for All BCBSIL Members

October 16, 2020

In November 2019, Blue Cross and Blue Shield of Illinois (BCBSIL) launched the Availity Claim Status tool for providers to check detailed claim status online for Medicare Advantage and Illinois Medicaid members. As of Oct. 19, 2020, this tool now includes detailed claim status for commercial, Federal Employee Program® (FEP®) and on- and off-exchange members. This improvement will help increase administrative efficiencies by offering you a single tool to check claim status online for all your BCBSIL patients.

Retired: Claim Research Tool
BCBSIL’s Claim Research Tool (CRT) in Availity has been retired as of Oct. 19, 2020. The detailed claim status information you received within the CRT for commercial, FEP and on- and off-exchange members, including applicable code audit rationale and additional action(s), have now been incorporated into the Availity Claim Status tool.

Enhanced: Availity Claim Status Tool
The Claim Status tool is found in the Claims & Payment menu on the Availity portal. It allows you to search for claims using a member ID or specific claim number. The claim status results are provided in real-time with information that’s more detailed than the HIPAA-standard 276/277 claim status transaction.  When searching by the member ID, the patient name will now be included in the list of claims returned, based on the search criteria entered. In addition, this claim status option returns 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
  • Transaction ID reference numbers

Webinar Training
Providers are encouraged to register for an upcoming Availity training to learn how to efficiently verify claim status online. To register for a session, simply click on one of the dates and times below.

Resources
For more information, refer to the Availity Claim Status User Guide  in the Provider Tools section of our Provider website. As a reminder, you must be registered with Availity to use the Claim Status tool. For registration information, visit Availity , or contact Availity Client Services at 800-282-4548.

If you have questions or need customized training, contact our Provider Education Consultants.

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.