The Availity® Essentials Claim Status tool offers enhanced, real-time claim status functionality to help you manage and resolve claims processed by BCBSNM for all of our members. This includes government programs (Medicare Advantage and New Mexico Medicaid), commercial, Individual Family Markets and Federal Employee Program® (FEP®) members.
The Claim Status tool is found in the Claims & Payment menu in Availity Essentials. You can search for claims by a Member ID or specific Claim Number. Claim status results provide more detailed information than the HIPAA-standard claim status 276/277 transaction.
Enhanced claim status responses include the following details (if applicable):
- Patient and provider data submitted on claims
- In-network and out-of-network patient liability breakdown
- Billing and rendering provider name and National Provider Identifier (NPI)
- Check number, check date and payee name
- Other carrier payment amount
- Ineligible reason codes and associated descriptions
- Transaction ID reference numbers
- Save and View Saved Searches
This tool is accessible to registered Availity Essentials users. If you aren’t registered, go to Availity and select "Get Started" to complete the online guided process, at no charge.
For additional instructions, refer to the Claim Status Tool User Guide.
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 BCBSNM. BCBSNM makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.