May 2019

Behavioral Health Providers: You have electronic options!

We're pleased to offer and support electronic options to help you streamline administrative functions in your office. Are you a registered Availity^® Provider Portal user? If not, we encourage you to visit availity.com to register now, at no cost. Soon you’ll be making the free online tools and resources listed below a part of your daily workflow. If you’re already a registered user, contact your Availity administrator for access to these tools in your Availity account.

Express Entry	You’ll find this option in the My Providers menu, once you log in to Availity. Express Entry allows the Availity administrator to add and manage provider information in your organization’s account. Complete provider information fields in one step on most transactions.
Eligibility and Benefits	Confirm patient coverage and check benefit details in real-time, 24 hours a day (with the exception of Sundays from 8 a.m. to noon).When you check eligibility and benefits, you’ll also get details on benefit preauthorization, if required, and applicable vendors.
Benefit Preauthorization	It’s easy to access iExchange^®, our online benefit preauthorization tool, via the Availity portal. Availity administrators may enroll to use iExchange via BCBSIL’s Payer Spaces – select the Resource tab, then “Pre Auth Registration.” (Note: This does not apply to HMO plans.)
Electronic Claim Submission	Submit electronic claims one at a time or in batch and receive confirmation upon acceptance. Advantages include greater security and accuracy of data, with faster processing and payment.
Claim Research Tool*	This tool offers enhanced claim status for commercial claims. (Tips:* Use the billing NPI submitted on the claim. Also make sure the date entered for the service period includes the actual date of service.)*
Claim Status	An electronic claim status inquiry (276 transaction) must be used to obtain claim status information electronically for government programs claims.
Reporting On- Demand	Use Reporting On-Demand to view, download or print duplicate copies of the provider claim summary.
Claim Inquiry Resolution*	Use this tool to request commercial claim review. (Note:* This tool should not be used for appeals.)*
Electronic Refund Management*	Receive and respond online to overpayment recovery requests on commercial claims.
Online Submission of Medical Records	Receive and respond to quality and risk adjustment medical record requests electronically via Availity’s Medical Attachments application.

As a reminder, if you don’t have online access, we have other user-friendly options, too. Our automated interactive voice response system (IVR) is available for real-time eligibility and benefits information for commercial 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. To verify eligibility and benefits via phone for government programs members, refer to the number on the member’s ID card.

For More Information

Provider Training – For an overview of electronic tools and resources on Availity, join us for a BCBSIL Back to Basics ‘Availity 101’ training webinar hosted by BCBSIL. To register for an upcoming session, refer to the Webinars page. To request a customized training, contact our Provider Education Consultant team at pecs@bcbsil.com.
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 for commercial providers to help you navigate our automated phone system for Claims, Eligibility and Benefits, and Behavioral Health Preauthorization, if applicable.

*These tools are not applicable for government programs claims.

Checking eligibility and/or benefit information and/or the fact that a service has been preauthorized 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. iExchange is a trademark of Medecision, Inc. (Medecision), a separate company that provides collaborative health care management solutions for payers and providers. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third-party vendors such as Availity or Medecision. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.