Blue Review
A newsletter for contracting institutional and professional providers

July 2020

Use the Availity® Authorizations Tool for Online Benefit Preauthorization Requests

As a reminder, iExchange® will be deactivated in the very near future. You are encouraged to transition and use the Availity Authorizations tool for electronic benefit preauthorization requests handled by Blue Cross and Blue Shield of Illinois (BCBSIL) for inpatient admissions and select outpatient services. Using this tool helps increase administrative efficiencies by permitting users to access and verify status of requests, upload supporting clinical documentation, update requests and obtain printable confirmation numbers.

Other Important Reminders

  • If you haven’t registered with Availity, you can sign up for free on the Availity website. For help, contact Availity Client Services at 800-282-4548.
  • The process of submitting benefit preauthorization requests through eviCore healthcare (eviCore) or other vendors is not changing.
  • Medical and surgical predetermination of benefits requests should be submitted via fax or mail by using the Predetermination Request Form, along with the pertinent medical documentation.
  • Always check the patient’s eligibility and benefits first to find out if benefit preauthorization may be required for the service and/or procedure code. For details on how to submit requests via the Availity, Provider Portal, refer to the General Eligibility and Benefits Tip Sheet.

For More Information
Refer to the educational Availity Authorizations User Guide located in the Provider Tools section of our website. If you have questions or would like to request customized training, email our Provider Education Consultants.

Please note that checking eligibility and benefits and/or the fact that a service has been preauthorized/pre-notified 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, 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., a separate company that provides collaborative health care management solutions for payers and providers. eviCore is an independent specialty medical benefits management company that provides utilization management services for BCBSIL. eviCore is wholly responsible for its own products and services. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Availity, Medecision or eviCore. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.