October 8, 2020
In Nov. 2019, Blue Cross and Blue Shield of New Mexico (BCBSNM) launched the Availity Claim Status tool for providers to verify detailed claim status online for Medicare Advantage members. Starting Oct. 19, 2020, this tool will include detailed claim status for commercial, Blue Cross Community CentennialSM, Federal Employee Program® (FEP®) and on and off exchange members. This improvement will increase your administrative efficiencies by offering you a single tool to check claim status online for all your BCBSNM patients.
This Claim Status tool is found in the Claims & Payment menu via the Availity portal and allows providers to search for claims by a member ID or specific claim number. When searching by the Member ID, the patient name will now be included in the list of claims returned, based on the search criteria entered. The claim status results are real-time and provide more detailed information than the HIPAA-standard 276/277 claim status transaction. In addition, this claim status option returns the following details:
- patient and provider data submitted on claims
- in-network and out-of-network patient liability breakdown
- billing and rendering provider name and NPI
- check number, check date and payee name
- other carrier payment amount
- ineligible reason codes and associated descriptions
- transaction ID reference numbers
BCBSNM Claim Research Tool Retirement
The BCBSNM Claim Research Tool (CRT) in Availity will be retired as of Oct. 19, 2020. The detailed claim status information you received within the CRT, including applicable code audit rationale and additional action(s), have been incorporated into the Availity Claim Status tool for commercial, Blue Cross Community Centennial, FEP and on and off exchange members.
Providers are encouraged to register for an upcoming Availity training to learn how to efficiently verify claim status online. To register for a session, simply click on one of the dates and times below.
- Oct. 19, 2020 – 9 to 9:30 a.m.
- Oct. 21, 2020 – 1 to 1:30 p.m.
- Oct. 23, 2020 – 10 to 10:30 a.m.
- Oct. 26, 2020 – 9 to 9:30 a.m.
- Oct. 27, 2020 – 2 to 2:30 p.m.
For additional instructions, refer to the Availity Claim Status User Guide in the Provider Tools section of our Provider website. As a reminder, you must be registered with Availity to use the Claim Status tool. For registration information, visit Availity , or contact Availity Client Services at 800-282-4548.
If you have additional questions, contact the Provider Education Consultants.
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.