Availity® Essentials
Register with Availity Essentials to verify eligibility and benefits, submit benefit prior authorization requests handled by BCBSIL,* obtain claim status, view provider claim summaries and more.
*You can also use BlueApprovRSM.
|
Availity Provider Portal
Availity Client Services – 800-282-4548
|
Behavioral Health Program
BCBSIL manages BH services for all commercial non-HMO members who have BH benefits through group/retail products. Similar BH programs are implemented across product lines but may differ by product.
|
Behavioral Health Contact Information
|
BlueCard Eligibility® Line
Call for out-of-state Blue Cross and Blue Shield member eligibility and benefits
|
800-676-2583
|
Carelon Medical Benefits Management
For commercial non-HMO prior authorization requests handled by Carelon.
|
Carelon Provider Portal
Carelon Contact Center – 866-455-8415 (Monday through Friday, 6 a.m. to 6 p.m., CT; and 9 a.m. to noon, CT on weekends and holidays)
|
Electronic Commerce Services
Contact us if you have questions about electronic transactions that cannot be answered by your clearinghouse or software vendor. Refer to our Electronic Commerce page for more information.
|
Email our Electronic Commerce Services team.
|
eviCore healthcare (eviCore)
For government programs (Medicare Advantage and Illinois Medicaid) prior authorization requests handled by eviCore.
|
eviCore Web Portal
eviCore toll-free – 855-252-1117 (Monday through Friday, 7 a.m. to 7 p.m., CT, except holidays)
|
Federal Employee Program® (FEP®)
Verify eligibility and benefits and/or check claim status for FEP members
|
800-972-8382
|
Fee Schedule Requests
For providers who are already participating in our Preferred Provider Option (PPO), Blue Choice PPOSM, Blue Choice PreferredSM, Blue Choice SelectSM, and Blue High Performance Network® (BlueHPN®) networks.
|
Refer to our Fee Schedule page for forms and instructions.
|
Fraud Hotline
Report concerns of potential fraud 24/7 to our Special Investigations Department (SID).
|
File a report online, or
Call the Fraud Hotline at 800-543-0867.
All inquiries are confidential, and you may remain anonymous.
|
Medical Management
If you have questions on a prior authorization request handled by BCBSIL, use our automated phone system to contact our Medical Management department.
|
Commercial (non-HMO) – 800-572-3089
Government Programs – 877-774-8592 (MA PPO); 877-860-2837 (BCCHP); 877-723-7702 (MMAI)
|
Pharmacy Programs
BCBSIL uses Prime Therapeutics LLC as our pharmacy benefit manager to administer our pharmacy program for eligible members.
|
Refer to our Pharmacy Programs section for details.
|
Provider Customer Service –Commercial
If you don’t have online access, call our Provider Telecommunications Center to use our automated phone system for eligibility and benefits, other self-service requests and claims inquiries.
|
800-972-8088 (Monday – Friday, 8 a.m. to 11:30 p.m. CT; Saturday – 6 a.m. to 3:30 p.m. CT; Sunday – Closed)
|
Provider Customer Service – Government Programs
Use these numbers for claims and other inquiries for Blue Cross Community Health PlansSM (BCCHPSM), Blue Cross Community MMAI (Medicare-Medicaid Plan)SM and Blue Cross Medicare AdvantageSM (HMO and PPO).
|
BCCHP – 877-860-2837
MMAI – 877-723-7702
Medicare Advantage – 877-774-8592
|
Provider Demographic Updates
If you need to change your existing demographic information [legal name; National Provider Identifier (NPI)/Tax ID; physical address(s), phone/fax number, email, hours of operation, etc.]:
|
See our Verify and Update Your Information page for instructions.
Complete our online Demographic Change Form.
|
Provider Learning Opportunities
Free training is available for providers, billing services, clinical and administrative staff who are new or already participating in the BCBSIL network.
|
To register, visit the Webinars and Workshops page.
For customized training, contact our Provider Education Consultant Specialist team.
|
Provider Network Consultants (PNCs)
Our PNCs can offer information on how to use online tools, BCBSIL products and initiatives, provider education opportunities and personalized office visits.
|
View Provider Network Consultant Assignments.
|
Provider Roster Requests
To request a roster for your practice, include your group name, NPI and Tax ID.
|
Email our Provider Roster Requests team.
|