Update: Predictal Precertification user Guide

*Applies to both Commercial and Medicaid Expansion

The Predictal guide has been updated to reflect a change in location where the provider fax number will be entered. Providers will now choose all provider details for the Ordering/Rendering Provider and the Service Facility before entering their fax number and submitter information. The fax number to place in this field is where applicable request details should go to. Below you will see an example of the change going into place.

Previously, the fax number would be entered at the top part of the Provider Details screen as shown here:

Predictal screenshot

Going forward, the placement of where to enter the fax number will be at the end of the Provider Details page:

Predictal screenshot

A few other things to keep in mind:

  • When selecting member or provider details, make sure to click the caret button to expand the information, then click to highlight the right person/address.
  • The save button will save your place in the authorization, submit will advance providers to the next screen.
    • Please note, if you save and do not go back into the request for an extended period, it may time out and you will need to restart the request.

When to contact Availity Essentials vs. BCBSND about Predictal. Availity Essentials

  • Dashboard questions.
  • Questions on submissions prior to seeing the Predictal acknowledgement screen.

BCBSND Provider Services

  • Questions on status if you cannot find it on your dashboard.
    • This can include authorization status, a request for rationale if you cannot locate it within in Availity.
  • Questions on issues within the Predictal tool.

Who you contact can make a difference.

  • Availity Essentials may not be able to assist you if you call with a question regarding the inner workings of the Predictal tool. However, our Provider Service department is equipped to receive those questions and assist.
  • The same can be said if you contact Provider Service with questions about your dashboard. The CCC does not have access to assist with Availity Essentials dashboard troubleshooting.

We appreciate the continued collaboration as we progress with this new tool. If you have any questions relating to the changes in the Predictal guide, please reach out to the Provider Services phone number on the back of the member ID card.