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Calling us for claim status?

November 10, 2010

Automated interactive voice response (IVR) phone systems have a dual reputation. Some users find them to be quick and easy. Others find them to be challenging. Convincing rationale for using IVR systems includes extended hours of availability, reliable information, and an alternative to waiting on hold. For offices with online access, we have also been communicating the positive aspects of obtaining patient information via Web-based transactions through Availity®’ or your preferred online vendor portal.

If your office has yet to adopt an electronic connectivity solution or only has limited online access, then the BCBSTX IVR offers the next best method for obtaining the information you need. Our IVR is designed to respond quickly and efficiently to address your requests for eligibility, benefits, and claim status information.

Claim Status Menu Changes in October

We are continuing to modify the IVR claim status menu options to better suit your needs. The IVR quotes claim status information at two levels:

  1. Overall status – check amount, paid date, etc.
  2. Line item detail (professional claims only) – allowable amounts, ineligible reason codes, etc.

Beginning Oct. 18, 2010, you will have the option to speak to a Customer Advocate (CA) only after you obtain responses via the IVR at both of the above claim status levels. By using the IVR, you allow our CAs to dedicate more time to addressing and resolving claim inquiries beyond status quotes.

Since the IVR pulls data directly from our claim system, claim status information quoted to you by the IVR is:

  • Current – The IVR provides the most updated claim status information available.
  • Accurate – Information quoted by the IVR will match your Provider Claim Summary (PCS) or Electronic Payment Summary (EPS).
  • Detailed – There are limited reasons to speak with a CA after obtaining information from the IVR, as the IVR and CA quote from the same source: our claim system.

For assistance with navigating the automated phone system, refer to the IVR Caller Guides, available in the Provider Library/Reference Guides section of our website at bcbstx.com/provider.

Availity is a registered trademark of Availity, L.L.C.

Availity, L.L.C. is an independent third party vendor and is solely responsible for its products and services 



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