July 16, 2019
One of the most convenient, efficient and secure methods of requesting detailed claim status from Blue Cross and Blue Shield of Texas (BCBSTX) is by using an online option such as the Availity Claim Research Tool (CRT)*. The CRT helps providers manage account receivables by viewing details of a single claim or statuses of multiple claims for a specific member in one view.
The CRT allows registered Availity users to search for claims by patient ID, group number and date of service, or by National Provider Identifier (NPI) and specific claim number, also known as a Document Control Number (DCN). The CRT also enables users to obtain real-time claim status, with detailed ineligible reason code descriptions.
The search results page delivers the rendering provider ID and name submitted on the claim. Additionally, the claim status service line breakdown returns:
- Service Date
- Revenue/Procedure Code
- Diagnosis Code
- Ineligible Reason Code and Amount
- Copay, Coinsurance and Deductible
- Unit or Time or Mile
This important information is available within a few clicks, lessening the need to speak with a Customer Advocate. For additional information, refer to the CRT tip sheet in the Education and Reference Center/Provider Tools section of our provider website. As a reminder, you must be registered with Availity to utilize the CRT. For registration information, visit , or contact Availity Client Services at 1-800-282-4548.
Join us for a webinar! BCBSTX hosts complimentary Back to Basics: ‘Availity 101’ Webinars for providers to learn how to use the CRT and other electronic tools to the fullest potential. You do not need to be an existing Availity user to attend a webinar. To register online now for an upcoming webinar, visit the Educational Webinar/Workshop Sessions page in the Education and Reference Center section of our Provider website.
*The CRT is not yet available for government programs claims. To check claim status in the Availity portal for government programs (Medicare Advantage and Texas Medicaid) claims, providers should use the Claim Status & Remittance Inquiry tool, instead of the CRT.
Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to Blue Cross and Blue Shield of Texas (BCBSTX). BCBSTX makes no endorsement, representations or warranties regarding any products or services provided by third-party vendors such as Availity. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.