Blue Review
A newsletter for contracting institutional and professional providers

November 2018

Behavioral Health Providers: Electronic Options, Training and Related Resources

We're pleased to offer and support electronic options to help you streamline administrative functions in your office.

We hope you were able to join us for our recent Electronic Options Training for Behavioral Health Providers webinar. We covered a lot of material in this training session, with an emphasis on tools available to registered users on the Availity® Provider Portal. Here’s a quick re-cap:

  • Express Entry – You’ll find this option in the My Providers menu. Tip: Make sure your Tax ID and National Provider Identifier (NPI) are accurate.
  • Eligibility and Benefits – Confirm patient coverage and check benefit details in real-time, 24 hours a day except Sundays from 8 a.m. to noon.
  • Electronic Claim Submission – Submit claims one at a time or in batch and receive confirmation upon acceptance.
  • Claim Status Inquiry – An electronic claim status inquiry (276 transaction) must be used to obtain claim status information electronically for government programs claims.
  • Claim Research Tool* – This tool offers enhanced claim status for commercial claims. Tips: Use billing NPI submitted on claim; make sure date entered for service period includes actual date of service.
  • Reporting on Demand* – This tool can be used to obtain duplicate copies of the provider claim summary.
  • Claim Inquiry Resolution* – This tool can be used to request claim review. Note: This tool should not be used for appeals.
  • Electronic Refund Management* – Receive and respond online to overpayment recovery requests.

*Tools marked with an asterisk are not applicable for government programs claims.

Note: Contact your Availity administrator for access if you do not have the above-referenced tool(s) in your Availity account.   

We also discussed the option of calling our automated interactive voice response system (IVR) for real-time eligibility and benefits information for BCBSIL members. Results are provided in real-time, along with a confirmation number. You have the option to have benefit details faxed to you for future reference. Customer advocates remain available to help with claim adjustments.

For More Information

  • Tip Sheets for Electronic Tools – Refer to the Provider Tools section of our website for tip sheets to help you navigate Availity Eligibility and Benefits, the Claim Research Tool, and more.
  • IVR Caller Guides – Three guides are available in the Related Resources section of our Provider website (claims, eligibility and benefits, behavioral health).
  • Additional Training – To request a customized training, contact our Provider Education Consultant team at pecs@bcbsil.com.

Checking eligibility and/or benefit information 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 applicable on the date services were rendered. If you have any questions, please call the number on the member’s ID card.

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.