Claim Status Option to Exit Automated Phone System

As announced previously, effective July 13, 2015, claim status will no longer be available through the Blue Cross and Blue Shield of Texas (BCBSTX) interactive voice response (IVR) phone system.

The IVR system will continue to prompt callers for the type of request (eligibility and benefits, claims, preauthorization or other services). The claims menu will include two options (adjust a claim and claim mailing address). As of July 13, 2015, the claims menu will no longer include options for claim status or claim number.

We’ve provided FAQs on the BCBSTX provider website to further assist you in this migration from the IVR to Web channels for determining your claims status.

Claim status information will continue to be available electronically through your preferred vendor portal. Among other advantages, using a vendor portal can help save your staff time by offering faster, more efficient returns on claim status requests and other inquiries.
 
Online claim status options offer the same real-time information formerly provided by the phone system, and more. For example, registered Availity^™ Web Portal users may access the Claim Research Tool, which allows searches by member ID, group number or DCN. You can check status of multiple claims in one view, view claims for a particular date range and obtain detailed line item information, such as amount paid, ineligible reason code and description for each service line.

Availity users also may access a remittance viewer tool to help view and interpret claim payment details on the 835 Electronic Remittance Advice (835 ERA) from BCBSTX. For more information on the Claim Research Tool and remittance viewer, visit the Education and Reference/Provider Tools section of the BCBSTX provider website. Also watch the Education and Reference section of our website for upcoming webinars.

Availity is a trademark of Availity, L.L.C., a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSTX. BCBSTX makes no representations or warranties regarding third party vendors such as Availity.