After submitting a claim, you can check the status online to verify if your claim has been received, pended or finalized. You can also verify the descriptions for any claim denials.
You or your billing agent can obtain real-time results by checking claim status through the Availity® Claim Status Tool. The Claim Status Tool provides the equivalent of an Explanation of Benefits (EOB), including line item breakdowns and detailed denial descriptions. All results are printable and can be used as a duplicate EOB for another insurance carrier when requested.
See our Claim Status tool user guide for more details.
Only registered Availity users can access the Claim Status Tool. If you aren’t registered, go to Availity and select “Register” to complete the guided online process, at no cost. If you don’t have Availity access, you may obtain basic claim status online by completing a claim status request (276 transaction) via your preferred web vendor.
Reminder: Don’t Submit Duplicate Claims
If your claim did not process the way you anticipated, it is important that you do not submit a duplicate claim for the same patient. Duplicate claims typically result in additional denials.
Adjust a Claim via Telephone
For commercial claims, if you have additional questions or need to request a claim adjustment, a document control number (claim number) is required when calling via our Interactive Voice Response (IVR) automated phone system to speak with an agent. To access our IVR system, call 888-349-3706. The system is available Monday through Friday, 5 a.m. to 10:30 p.m., MT, and Saturday, 5 a.m. to 5 p.m., MT. For additional details, refer to the Claims Caller Guide.
For government programs claims, if you don’t have online access through a vendor, you may call the below customer service phone number to check claim status or make an adjustment:
- Blue Cross Community Centennial claims – call 800-693-0663
- Medicare Advantage claims – call 877-774-8592
Email our Provider Education Consultants. Be sure to include your name, direct contact information, tax ID or billing NPI.
- Claim Status Tool User Guide
- Claim Inquiry Resolution (CIR) Tool
- Claims Caller Guide
- See How Your Claim May Process
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 BCBSNM. BCBSNM 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.