January 2019
Automated Phone System Change for Behavioral Health Services
Checking eligibility and benefits electronically through the Availity® Provider Portal or your preferred web vendor is the quickest way to access behavioral health coverage information for Blue Cross and Blue Shield of Illinois (BCBSIL) members. Online eligibility and benefit quotes include the patient’s coverage status and benefit details, such as applicable copayment, coinsurance, deductible amounts and benefit preauthorization requirements, if applicable.
If you do not have online access and need to call BCBSIL to verify patient coverage for behavioral health services, as of Dec. 16, 2018, you must first obtain eligibility and benefit details through the BCBSIL Interactive Voice Response (IVR) phone system. The IVR quotes the same level of eligibility and benefit information as a Customer Advocate provides. Our Customer Advocates will continue to be available for additional assistance and more complex benefit quotes.
Please note that the IVR main menu options have been reordered. When using your touch-tone key pad, select "1” for Medical, “2” for Pharmacy, “3” for Dental, or “4” for Behavioral Health. The ordering of the IVR main menu does not affect callers who use voice commands to respond to prompts.
Learn More
To learn more about electronic options, refer to the Provider Tools page in the Education and Reference Center of our Provider website. For IVR navigational assistance, refer to the Eligibility and Benefit Caller Guide located in the Claims and Eligibility section.
Government Programs Note: To verify eligibility and benefits via phone for government programs (Medicare Advantage and Illinois Medicaid) members, refer to the number on the member’s ID card.
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.