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Availity® Provider Portal Offerings

October 28, 2020

The Availity provider engagement portal helps providers and Blue Cross and Blue Shield of Oklahoma (BCBSOK) to securely share information easily and efficiently. Using Availity allows you to quickly verify patient eligibility and benefits, confirm prior authorization requirements, submit prior authorization requests, check claim status, obtain provider claim summaries, and more without having to call BCBSOK.

Advantages of using Availity

  • Accessible 24/7
  • HIPAA Compliant
  • Multi-Payer Solution
  • Real-time Search Results
  • No Cost Transactions
  • Printable Results
  • Online Help Features

Electronic Provider Tools

The following complimentary self-service tools are accessible through Availity and can be used to accomplish multiple tasks and gain information.

Pre-Service ToolsDescription
Eligibility and Benefits Inquiry verify real-time patient activity, check coverage details and determine prior authorization requirements
Patient Care Summary consolidated view of a patient’s health care history
Patient Cost Estimator* estimate a patient’s potential out-of-pocket costs
Patient ID Finder* obtain the BCBSOK patient ID and group number
Attachments* submit predetermination of benefits requests handled by BCBSOK
Authorizations & Referrals submit prior authorization & referral requests handled by BCBSOK
Post-Service ToolsDescription
Claim Status check detailed, real-time claim status
Research Procedure Code Edits (Clear Claim Connection)* determine how coding combinations on a specific claim may be evaluated during the adjudication process
Reporting On-Demand view, download, save and/or print the Provider Claim Summary (PCS) for finalized claims
Remittance Viewer offers providers and billing services a convenient way to view and help reconcile claim data in the 835 Electronic Remittance Advice (ERA)
Electronic Refund Management (eRM)* reconcile claim overpayments and manage refund requests
Claim Inquiry Resolution (CIR)* submit claim reconsideration request for certain finalized claims
Medical Attachment
(Electronic Quality and Risk Adjustment Medical Records Requests)		 receive and electronically respond to medical record requests for quality and risk adjustment
Clinical Quality Validation
(CQV)		 comply with Healthcare Effectiveness Data and Information Set (HEIDIS) measures by electronically documenting the patient’s care and assessment

*Not available for Medicare Advantage members.

If you have not yet registered for Availity Learn more about third-party links, you can sign up today at no charge. For registration assistance, you may contact Availity Client Services at 800-282-4548.

For More Information

Refer to the Provider Tools section of our website for detailed information and applicable user guides for the Availity offerings. Additionally, you can visit our Training page to register for upcoming online training sessions.

Have additional questions or need customized training? Email our Provider Education Consultants for assistance.

Checking eligibility and/or benefit information is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage applicable on the date services were rendered. If you have any questions, please call the number on the member’s ID card.

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 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.

ClaimsXten and Clear Claim Connection are trademarks of Change Healthcare, an independent company providing coding software to BCBSOK. Change Healthcare is solely responsible for the software and all the contents. Contact the vendor directly with any questions about the products, software and services they provide.