Availity Provider Portal Eligibility and Benefits Verification

Blue Cross Blue Shield of North Dakota (BCBSND) is providing monthly tips reminding providers of functionality in our Availity Provider Portal. This month’s Availity tip is verifying eligibility and benefits.
 
Did you know that you can verify the following eligibility and benefits for the following members?

  • BCBSND Members
  • BCBSND Dental Members
  • NextBlue of North Dakota Medicare Advantage Members
    • Select the NextBlue option in the drop-down menu prior to running verification
  • Out-of-state BlueCard Members
    • Amount of detail in the response varies by plan
    • If additional information is needed, call the number on the back of the member’s insurance card
  • International Blue Plan Members
    • Verify eligibility and benefits using one of three methods:
      • Send an electronic inquiry through the Availity Provider Portal
      • Submit a HIPAA 270 transaction (eligibility) to BCBSND
      • Call the BlueCard Eligibility® line at 800-676-BLUE (2573) and provide the prefix

Eligibility and benefit tips:

  • Out-of-state BlueCard plans and out-of-state Medicare Advantage plan verification
    • Call the number on the back of the member’s insurance card
  • Search previous dates of service
    • The system “as of date” defaults to the current date of service
      • Providers can search previous dates of service
  • Verify up to 50 members' eligibility at one time
    • Simply add multiple members by separating one patient per line and commas
      • Formatted example shown
    • Once the verification is received, review the patient history list for up to the next 24 hours
  • The patient history card status responses are color coded:
    • Green card: Member is active with no errors
    • Red card: Members insurance is inactive—termination date often displays
    • Orange card: Request or communications error occurred
      • Message displays with details of the error
        • Correct the errors by selecting the edit option 

As a BCBSND provider, you may be already registered with the Availity Provider Portal. If not, we encourage you to register at Portal Registration. Whether you are a current user or new to Availity, we encourage providers to take advantage of on-demand Availity Portal Training. To access the Availity Training center as shown below:

  • Log in to your Availity account and click on “Payer Spaces” located on the navigation bar
  • Access “Resources”
  • Enroll in the “Eligibility and Benefits” on-demand training

For more information on how to register, and the variety of tools that are available to you, contact Availity.

  • Contact Client Services at 1-800-282-4548
    • Monday through Friday, 8 a.m. to 7:30 p.m. EST 

Availity website: https://www.availity.com