2. Select “Eligibility and Benefits Inquiry”
3. Select the “Payer”
4. Complete the member information for the request
5. Click “Send”
6. Navigate the results
o If additional questions are needed select “Message this payer” located in the upper right-hand corner of your result
7. Select the “Reason for message”
8. Click “Send”
Direct Messaging Tips
Tips for direct messaging when choosing “other”. The option “other” allows a provider to ask questions related to general eligibility & benefits or basic claim questions. When using other be as detailed as if you were making a call to BCBSND Provider Contact Center. An example of incomplete information would be: Claim denied? This is not enough information to answer your question and you may be asked to contact the Provider Contact Center.
Prior to asking claim questions, review the online resources first through claim status. Often basic questions can be answered.
The claim status tool allows the provider to review:
- Status of the claim (Color coded):
- Green- finalized and paid by the payer
- Yellow- pending with payer
- Red- finalized and denied by the payer
- Billed/Paid amount
- Process date
- Correct or void a claim to create a new claim
**Note: When performing a claim status search always use the same Billing NPI used on the claim, or you will not find the matching claim in the system. If you want multiple claims to return a status for a specific member, use a date span.
Accessing the remittance review from the claim status tool allows the provider to review the payment information on their own, saving the provider time from having to make a phone call to our Provider Contact Center.
- Remittance viewer provides payment information
- Provider can search by the following options:
- Search by check/EFT or claim
- Provider NPI
- Select date range
- Use filter options
Reviewing your Direct Messaging
To review your message returned from BCBSND access the Availity home page, in the upper right-hand corner under Messaging you will see your unread, pending and recently resolved messaging. Click the hyperlink to review the messages.