Availity BCBS Making Healthcare Easier

Availity BCBS is making healthcare easier by streamlining the billing and insurance process. This allows healthcare providers to focus on patient care, not administrative tasks.

With Availity BCBS, providers can access patient information and claims status in one place, reducing the need for phone calls and paperwork. This saves time and resources for both providers and patients.

Availity BCBS also provides a user-friendly platform for providers to manage patient data, including demographics, insurance information, and medical history. This ensures accurate and up-to-date information is always available.

By simplifying the healthcare process, Availity BCBS is helping to improve patient outcomes and satisfaction.

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Availity BCBS offers a range of provider resources to help you manage your practice efficiently.

You can log in to Availity to access various tools and features, including eligibility and benefits information, claim submission, and claim status updates.

Availity Essentials is replacing NaviNet as the provider portal for Horizon Blue Cross Blue Shield of New Jersey, Braven Health, and Horizon NJ Health. You can sign up and start using Availity Essentials to access self-service tools like eligibility and benefits, claim submission, and claim status.

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Availity Essentials will transition all features and functions in phases. You can check out the Payer Spaces to access additional applications, including the Cost Share Estimator and HorizonDocs.

To get started with Availity Essentials, you can access the Payer Spaces to find more information and sign up.

Here are some key features of Availity Essentials:

Some users are experiencing issues with Availity, specifically when requesting prior authorizations for members effective 1/1/2024. This is due to membership error issues.

If you encounter an error, please submit a fax to 307-432-2917. We're working with Availity to resolve this issue.

The No Surprises Act requires confirmation of information every 90 days. This is a mandatory requirement.

Here are some topics that will be covered in future updates:

For Digital Breast Tomosynthesis (DBT) services, BCBSWY requires specific CPT codes for reimbursement. BCBSWY will only reimburse DBT services billed using CPT codes 77063 and G0279.

These codes represent DBT being performed as an add-on service. DBT services billed using code 77061 or 77062 will be denied.

To ensure accurate billing, make sure to use the correct CPT codes: 77063 – Screening digital breast tomosynthesis, bilateral; add-onG0279 – Diagnostic digital breast tomosynthesis, unilateral or bilateral; add-on

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Understanding Proper Authorization Request is crucial for smooth billing and reimbursement.

BCBSWY has received numerous questions regarding the Drug Prior Authorization box on Availity, so it's essential to know that it's not used by BCBSWY.

All authorizations, including drugs, should use the AUTHORIZATION REQUEST box regardless of CPT or HCPCS code.

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Digital Breast Tomosynthesis Billing requires attention to detail to avoid denials. BCBSWY will only reimburse Digital Breast Tomosynthesis (DBT) services billed using CPT codes 77063 and G0279.

These codes represent DBT being performed as an add-on service, and it's essential to note that services billed using code 77061 or 77062 will be denied. To avoid this, make sure to use the correct codes for your DBT services.

The following CPT codes currently represent DBT services:

Remember, using the correct codes is crucial to avoid denials and ensure timely reimbursement for your DBT services.