Availity Provider Portal
Issue: #405 DEC2018
The Availity Provider Portal offers the following electronic capabilities:
- Eligibility and Benefits Verification
- Claim Status Inquiry
- Institutional and Professional Claim Direct Data Entry
- Electronic Remittance Advice Viewer
To access the Availity Provider Portal and check out helpful resources, navigate to www.Availity.com/BCBSND.
Questions regarding the portal? Contact Availity Support at 1-800-282-4548
- Therapy benefit limits: Blue Cross Blue Shield of North Dakota (BCBSND) has heard from some providers that therapy benefit limits don’t display in Availity. The good news is this benefit information is available, providers just need to change a setting to get to the information. Benefits and information returned will vary based on the service type code selected when running an Eligibility & Benefits transaction. These service type codes are primarily defined and established by the Workgroup for Electronic Data Interchange (WEDI) and Washington Publishing Company (WPC), which publishes EDI support and tools. As seen in the screenshot below, the default service type is Health Benefit Plan Coverage, but you can change the service type.
- Looking up Migrated Member ID: BCBSND understands that patients don’t always bring in their new ID cards, which is why Availity has made it possible to cross reference the patient’s old member ID to the new unique member ID (UMI) when doing an Eligibility & Benefits transaction. Below is a screen shot of what displays in the Availity Portal when looking up a migrated member using their old member ID. The section outlined in red will display the new migrated ID number that can be used to look up patient information and file claims.
If you do not have your patient’s new or old UMI number, reach out to the patient to receive that information or call Provider Service.