Administrative Digital SolutionsCommercialFebruary 1, 2024

Update: Training for digital requests for additional information (Digital RFAI)

Now accepting Medicaid and Medicare member claims

As a care provider taking advantage of digital requests for additional information (Digital RFAI), you know it is the most efficient way to send the required documentation to process your Commercial member claims. As of February, you also can receive Digital RFAI notifications for your Medicaid and Medicare member claims.

The process will not change for Medicaid and Medicare member claims. You will still follow the same fast and easy process for our Medicaid and Medicare member claims as you do for your commercial member claims. The only difference is that your Medicaid and Medicare member claims will not pend. Medicaid and Medicare member claims will deny when additional documentation is needed to process the claim.*

Notifications will remain on your dashboard for up to 30 days for pended claims as they do today and 45 days for denied claims. After that, these notifications will move to the history tab of your dashboard. Submit the documentation at your convenience (most care providers submit documents within seven to 14 days).

Your notifications will continue to arrive on your dashboard each morning, making it convenient to plan your work; no need to check your dashboard throughout the day.

* Claims for providers under pre-payment review will pend for 30 days.

Learn more!

In collaboration with Availity, we’ve developed training for your organization’s administrators about how to update the Medical Attachment registration.:

Availity administrators can use this link to register for live training or to view the training on demand.

For associates who are responsible for sending attachments, we’ve developed an enhanced training session that walks through the Attachments Dashboard and many of the unique features that make it most efficient.

Availity users with the Medical Attachments and Claims Status role assignment can use this link to register for live training, or to view the live training on-demand.

Contact Availity Customer Support at availity.com/Contact-Us or your provider relationship representative if you have any questions.

Not a Digital RFAI care provider?

If you’re not already using the Digital RFAI process and want to take advantage of faster claims processing, participation is easy.

1.

Registration

The organization’s Availity administrator will register for Medical Attachments, which enables care provider organizations to receive notices from the payer and submit requested documents digitally.

All billing NPIs/TINs must be registered.

2.

User roles

The Availity administrator will be required to update or add new users with these specific role assignments through Availity:

  • Claims Status
  • Medical Attachments

Enable users to view the Availity Attachment Dashboard.

3.

Ready to go!

After the registration and user roles are completed on Availity, the Digital RFAI process is ready.

Requests will automatically appear on the Attachments Dashboard each morning (when documents are needed).

We are committed to finding solutions that help our care provider partners offer quality services to our members.

Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

MULTI-BC-CM-049151-23-CPN48758

PUBLICATIONS: February 2024 Provider Newsletter