May 20, 2022
As of May 22, 2022, you can electronically initiate one clinical claim appeal request for multiple claims, when it’s for the same patient and denial reason, using the Availity® Claim Status tool.
As a reminder, a Clinical Appeal is a request to change an adverse determination for care or services when a claim is denied based on lack of medical necessity, or when services are determined to be experimental, investigational, or cosmetic.
By using the online appeal request option, you can:
- Check/manage status
- Upload clinical medical records with submission
- View and print confirmation and decision letter
- Generate a Dashboard view of appeal-related activity
Training and Resources
- Refer to the Webinars and Workshop page to register for the “Claim Status and Clinical Claim Appeals” webinar hosted weekly by Blue Cross and Blue Shield of Illinois (BCBSIL).
- View the Electronic Clinical Claim Appeals User Guide in the Provider Tools section of our website for step-by-step instructions.
- Email our Provider Education Consultants if you have questions or need customized training.
If your provider organization is not yet registered with Availity, you can sign up today on Availity Essentials, at no charge. For registration help, call Availity Client Services at 800-282-4548.
This information is not applicable to Medicare Advantage, Illinois Medicaid, or BlueCard® (out-of-area) claims.
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.