Billing Agent Caller Reminders

Blue Cross Blue Shield of North Dakota (BCBSND) is reminding providers who employee third party billing agents and/or vendors with tools and resources to make calls more efficient, effective, and in a timely manner. It is important for us to provide the highest level of service to your agents and vendors. Listed below are those tools and resources.

Call Requirements
Prior to calling, ensure that your staff is prepared with the following information:

  • Member UMI or DOB
  • Member name
  • Rendering provider’s name
  • For claims, this name must match the provider on the claim to release information
  • Rendering provider NPI number; For claims, this NPI must match what is on the claim to release information

Call Reminders
Listed below are a few reminders for billing agent calls:

  • Inquiries limited to 5 members per call
  • If your staff places our advocate on hold, we will hold for 2 minutes and disconnect the call
  • If staff calls regarding claims that we have provided information on within the past 14 business days, we will refer the caller back to their colleague’s notes or Availity for the information
  • We will not review the processing details of claims that processed without denials
  • This information can be found in Availity
  • Availity Remit Viewer will provide the answers to many questions that we receive calls for
  • Availity Learning Center Portal Training
  • Availity provides tracking information, so if your Agent needs a tracking number for the research preformed, they can utilize the Availity tracking information for this purpose
  • Requests for copies of the Fee Schedule
  • We will not provide a copy of a fee schedule directly to a Billing Agent. If requested, we will send it to the direct office of the provider on file.
  • If you are looking for the reject reason that matches the ANSI code, you may find this information here:

Availity Provider Portal Access
The Availity Provider Portal offers an efficient and comprehensive tool for reviewing claims, eligibility, and benefits information for our BCBSND members. Determining your third-party staff has appropriate access to Availity will allow your staff access to:

  • Submit eligibility and benefits inquiries for BCBSND members
  • Submit claims and review status
  • Correct and void claims
  • View your electronic remittance advice (835)
  • Direct messaging* (Commercial side only)

As a BCBSND Provider, you may be already registered with the Availity Portal Registration, 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

Availity Questions:
Contact Client Services at 1-800-282-4548

  • Monday through Friday, 8 a.m. to 7:30 p.m. EST

Website: https://www.availity.com

Requests for Copies of the Provider Remit
The billing agency must reach out to the billing provider for a copy of the remit.

  • Remits are available in Availity
    • If the claim is in iClaims/Legacy, the agent will need to contact their provider and if they do not have the remit, the provider must reach out to us to obtain it

Requests for Claim Status
Providers with questions on claim status, review the following:

  • Still in Process submitted less than 30 days ago; we will not provide status information for claims submitted less than 30 days ago
  • Claims information can be found on Availity
  • Processed with no issues/denials; if there is no denial on the claim, all the information can be found on Availity using the remit viewer
  • We will not provide this information over the phone
  • Claim requests for DOS 2018 or older, BCBSND has limited access to this information and may not be able to find your claim
    • Any claim submitted now for DOS this old will be returned to you as “past timely filing.”

For additional questions reach out to the Provider Contact Center at 1-800-368-2312.