Claim Status and Adjudication

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.

Check Claim Status Online
You or your billing agent can obtain real-time results by checking claim status through Availity® Essentials Claim Status tool. The Claim Status tool provides the equivalent of an Explanation of Benefits, 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. For more additional instructions, refer to the Claim Status Tool User Guide.

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.

Provider Customer Service
For commercial claims, call our Interactive Voice Response automated phone system at 800-972-8088. 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. A document control number (claim number) is required when requesting to speak with an agent to make an adjustment. For more information, see our Claims Caller Guide.

For government programs claims, if you don’t have online access through a vendor, you may call provider customer service to check claim status or make an adjustment:

  • Blue Cross Community Health PlansSM – 877-860-2837
  • Blue Cross Community MMAI (Medicare-Medicaid Plan)SM – 877-723-7702
  • Blue Cross Medicare AdvantageSM – 877-774-8592

Reminder: Don’t Submit Duplicate Claims
If your claim didn’t process the way you anticipated, it’s important that you don’t submit a duplicate claim for the same patient. Duplicate claims typically result in additional denials.

Questions on electronic options?
Email our Provider Education Consultants. Be sure to include your name, direct contact information, tax ID or billing National Provider Identifier.

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