Claim Status

Checking Online

After submitting a claim, you can check the status online to verify if your claim has been received, pended or finalized. You can also verify the descriptions for any claim denials.

You or your billing agent can obtain real-time results by checking claim status through the Availity® Essentials Claim Status tool. The Claim Status tool provides the equivalent of an Explanation of Benefits (EOB), including line-item breakdowns and detailed denial descriptions. All results are printable and can be used as a duplicate EOB for another insurance carrier when requested. See our Claim Status tool user guide for more details.

Only registered Availity users can access the Claim Status Tool. If you aren’t registered, go to Availity and select "Get Started" to complete the guided online registration process, at no cost. If you don’t have Availity access, you may obtain basic claim status online by completing a claim status request (276 transaction) via your preferred web vendor.

Reminder: Don’t Submit Duplicate Claims

If your claim did not process the way you anticipated, it is important that you do not submit a duplicate claim for the same patient. Duplicate claims typically result in additional denials.

For non-participating providers claim appeals, refer to the Surprise Billing Provisions of No Surprises Act article on our News & Updates section.

Adjust a Claim via Telephone

For commercial claims, if you have additional questions or need to request a claim adjustment, a document control number (claim number) is required when calling via our Interactive Voice Response (IVR) automated phone system to speak with an agent. To access our IVR system, call 800-496-5774. The system is available Monday through Friday, 6 a.m. to 11:30 p.m., CT, and Saturday, 6 a.m. to 6 p.m., CT

For additional details, refer to the Claims Caller Guide.

For Medicare Advantage claims, if you don’t have online access through a vendor, you may call 877-774-8592 to check claim status or make an adjustment.

Questions

Email our Provider Education Consultants. Be sure to include your name, direct contact information, tax ID or billing NPI.

 

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 BCBSOK. BCBSOK makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.