Blue Cross Blue Shield of North Dakota (BCBSND) is reminding providers who employ third party billing agents and/or vendors about tools and resources available to make calls more efficient, effective and timely. It is important to utilize these tools and resources for us to provide the highest level of service to your agents and vendors.
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
Listed below are a few reminders for billing agent calls:
- Inquiries are limited to five members per call.
- If your staff places our advocate on hold, we will hold for two minutes. After two minutes, advocates are directed to disconnect the call.
- If your staff calls regarding claims 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 can provide answers to many questions we receive.
- Availity Learning Center Portal Training can also provide instruction.
- Availity provides tracking information, so if your Agent needs a tracking number for the research performed, they can utilize the Availity tracking information for this purpose.
- 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 the 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. Ensuring 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
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 the on-demand Availity Portal Training.
Contact Client Services at 1-800-282-454
- Monday through Friday, 8 a.m. to 7:30 p.m. (EST)
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, please review the following:
- We will not provide status information for claims submitted less than 30 days ago; claims with the “Still in Process” status.
- Claims information can be found on Availity.
- All the information on claims with the “Processed” status (with no issues/denials) can be found on Availity using the remit viewer.
- We will not provide claim status information over the phone.
- Please note, BCBSND has limited access to claim requests for DOS 2018 or older and may not be able to find your claim.
- Any claim submitted now for DOS 2018 or older will be returned to you as “past timely filing.”
For additional questions reach out to the Provider Contact Center at 1-800-368-2312.