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BLUE REVIEWSM

for Providers

December 2023

Provider Learning Opportunities

Blue Cross and Blue Shield of Illinois offers free workshops and webinars for the independently contracted providers who work with us. These trainings focus on electronic options and other helpful tools and resources. A preview of upcoming training sessions is included below. For more information, refer to our Webinars and Workshops page.

BCBSIL WEBINARS
To register now for a webinar on the list below, click on your preferred session date.

Descriptions:

Dates:

Session Times:

Availity® Essentials and BlueApprovRSM Prior Authorization Tools
 Learn how to electronically submit inpatient and outpatient prior authorization handled by BCBSIL using the Availity Authorizations tool. You’ll also learn how to access and submit inpatient and/or outpatient medical/surgical, behavioral health and specialty pharmacy drug prior authorization requests through BlueApprovR.

Dec. 6, 2023
Dec. 13, 2023
Dec. 20, 2023
Dec. 27, 2023

11 a.m. to 12:30 p.m.

Availity Essentials Claim Status, Clinical Appeals, Reconsiderations and Message This Payer
Learn how to verify claim status, submit and monitor clinical claim appeals and reconsiderations and Message This Payer online using the Availity Essentials Portal.

Dec. 7, 2023
Dec. 14, 2023
Dec. 21, 2023
Dec. 28, 2023

11 a.m. to 12:30 p.m.

Availity Essentials Instructor-Led Training
 Register for this session to better understand how electronic transactions can work for your organization. You’ll learn the importance of Manage My Organization, how to use the Patient ID Finder, instruction on the newly updated Eligibility and Benefits capability, and the Electronic Predetermination process.

Dec. 19, 2023

11 a.m. to noon

Availity Remittance Viewer and Provider Claim Summary
These online tools give providers and billing services a convenient way to view claim detail information from the 835 Electronic Remittance Advice and the Provider Claim Summary. Attend a webinar to learn how to gain or grant access, conduct a search, view general and payer-specific information, and save or print results.

Dec. 21, 2023

1 to 2 p.m.

BlueApprovR: Prior Authorization Process
Learn how to access BlueApprovR via Availity Essentials to submit and secure real-time approvals for specialty pharmacy drug, behavioral health clinical evaluation and medical surgical prior authorization and recommended clinical review requests for many BCBSIL commercial members.

Dec. 14, 2023
Dec. 21, 2023
Dec. 28, 2023

1 to 2 p.m.

Blue Cross Medicare Advantage (PPO)SM and Blue Cross Medicare Advantage (HMO)SM Provider Orientation
 Effective Jan. 1, 2023, BCBSIL’s Medicare Advantage Plan expanded to additional counties within Illinois. These orientation webinars will give you the opportunity to ask the Provider Network Consultants questions and will highlight topics such as provider enrollment, eligibility and benefits, claim submission and review and additional resources.

Dec. 6, 2023

1 to 2 p.m.

BCCHPSM and MMAI Required Provider Training Webinars 
If you provide care and services to our Blue Cross Community MMAISM and/or Blue Cross Community Health PlansSM members, please join us for guided webinars that will review all the provider trainings required by the Centers for Medicare & Medicaid Service and/or Illinois Department of Healthcare and Family Services.

Dec. 12, 2023
Dec. 14, 2023

10 a.m. to noon
1 to 3 p.m.

Coding for Vascular Disease
 Join our Coding Compliance team for a webinar on coding and guidelines for vascular disease.

Dec. 15, 2023

Noon to 12:30 p.m.

HEDIS® Update and Best Practices for Providers Groups
 This session will highlight how Healthcare Effectiveness Data and Information Set tracks measurement to improvement in quality reporting. Discussion also includes HEDIS methods and electronic clinical data systems.

Dec. 13, 2023

Noon to 1 p.m.

Monthly Provider Hot Topics Webinar
 Stay up to date on the latest news from BCBSIL! Engage with our PNCs to learn about upcoming initiatives, program changes and updates, and general network announcements.

Dec. 14, 2023

10 to 11:30 a.m.

Orientation Webinars for New Commercial Providers
 Learn how we can best work together to support better health outcomes for our members. Ask questions and engage with our PNCs on topics such as care coordination, third party vendors, claims, prior authorization and required provider training.

Dec. 13, 2023

1 to 2:30 p.m.

Orientation Webinars for New BCCHP and/or MMAI Providers
 Learn how we can best work together to support better health outcomes for our members. Ask questions and engage with our PNCs on topics such as network participation and benefits, claims, post-processing claim inquiries, supplemental resources, credentialing and contracting.

Dec. 7, 2023

10 to 11 a.m.

Provider Resource Webinar
 This webinar will offer additional information and resources to help BCBSIL providers resolve common topics of concern for commercially contracted providers.

Dec. 7, 2023

1 to 3 p.m.

Website Review Webinar
 Join us for a tour of the BCBSIL Provider website. The information covered will include both government programs and commercial lines of business.

Dec. 6, 2023

10 a.m. to noon

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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 and the products and services they offer.

HEDIS is a registered trademark of NCQA.

Checking eligibility and benefits and/or obtaining prior authorization is not a guarantee of payment of benefits. Payment of benefits is subject to several factors, including, but not limited to, eligibility at the time of service, payment of premiums/contributions, amounts allowable for services, supporting medical documentation, and other terms, conditions, limitations, and exclusions set forth in the member’s policy certificate and/or benefits booklet and or summary plan description. Regardless of any prior authorization or benefit determination, the final decision regarding any treatment or service is between the patient and the health care provider. If you have any questions, call the number on the member’s BCBSIL ID card.