Availity Reminders for Shared Admin and BlueCard Members
How do I look up Shared Administration claims in Availity?
For Shared Administration claim searches in Availity, use the Other Blue Plans Premera BlueExchange Shared Admin payer, enter all required fields, and be sure to enter the relationship to the subscriber. If the claim isn’t for the subscriber, you must enter the subscriber relationship and name in order for the claim to display:
Can I do a BlueCard or Shared Administration member eligibility and benefit search by member ID using Premera as the payer?
If you use Premera as the payer for a BlueCard and Shared Administration member eligibility and benefit member ID search, the response will come back stating no member found. For BlueCard and Shared Administration member eligibility and benefit searches, use “Other Blue Plans Premera BlueExchange Shared Admin” as the payer and enter all the information for the member (including member prefix, ID, and suffix) in the Patient ID field. This information is required to direct the request to the correct Blue plan for a response.
How do I look up BlueCard claims in Availity?
For BlueCard claim searches in Availity, use the Premera Blue Cross or Premera Blue Cross Blue Shield of Alaska payer to see detailed information about a claim Premera has processed. Providers can search for a BlueCard claim by date of service or claim number. Note: BlueCard claim searches using a Premera payer will not include the Patient Name or Member ID. You can identify a BlueCard member by your Patient Account #.
Where is the benefit information for acupuncture, chiropractic, or physical therapy?
To view information about a specific benefit, select “Acupuncture,” “Chiropractic,” or “Physical Therapy” under the Benefit/ Service Type when running an eligibility and benefits transaction.
Note: If there isn’t a limit listed, there is no yearly limit. However, medical necessity and billing guidelines still apply.
For more information
To help you get the most out of your Availity tools, view our new Availity Tips and Resources video tutorial or check out the user guide.