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.

Using the Claim Status Tool

You or your billing agent can obtain real-time results by checking claim status through the Availity^® 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. For more information 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 "Register" to complete the guided online 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, if you have additional questions, call our Interactive Voice Response (IVR) automated phone system at 1-800-451-0287. A document control number (claim number) is required when requesting to speak with an agent. 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 government programs claims, if you do not have online access, you may call provider customer service to check claim status or make an adjustment.

• Blue Cross Medicare Advantage^SM – 1-877-774-8592
• Texas STAR, CHIP – 1-877-560-8055
• STAR Kids – 1-877-784-6802

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.

Corrected Claims

If you have determined that a corrected claim is needed, submit an electronic replacement claim with the appropriate claim frequency code. For additional information, refer to Electronic Replacement/Corrected Claim Submissions .

Adjust Claim

If you need to request a claim adjustment, you can complete and submit the Claim Review form . For additional information refer to the Claim Review Process or Provider Manuals. You can also use the "Adjust a Claim" option within the IVR phone system to connect with an agent and request claim adjustments at 1-800-451-0287.

Questions

Email our Provider Education Consultants. Be sure to include your name, direct contact information, tax ID or billing National Provider Identifier (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 Blue Cross and Blue Shield of Texas (BCBSTX). BCBSTX 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.