To help ensure accuracy and eliminate delays in the adjudication of your claims, the itemized bill must be included with qualifying claim submissions. Submitting an itemized bill (unsolicited* medical attachment) for a high dollar claim just got easier!

 

To submit an itemized bill (unsolicited medical attachment):

  1. Log in to Availity Portal
  2. Select Claims & Payments | Attachments – New
  3. Select Send Attachment
  4. Under Request for Information, select No, if you are including the supplemental information/attachment for an 837 claim PWK. (see example below)





Providers can also submit a claim attachment using the Availity Portal for solicited** medical attachments.

 

To submit supporting documentation in response to a formal (solicited) request from the payer:

  • Log in to Availity Portal
  • Select Claims & Payments | Attachments – New
  • Select Send Attachment
  • Under the Request for Information, select Yes, if you are responding to a request from the health plan or need to submit documentation for a specific claim number (see example below)
  • Add supporting documentation and reason
  • Submit


 

Additionally, if you attended a previous webinar, we have updated information on submitting an EDI 837 batch that includes a PWK segment in loops 2300/2400. The update is regarding the linkage between the electronic claim and your supplemental documentation that can be submitted through the Availity portal.

 

What does this mean for you?

You may now submit attachments electronically (EDI) using the PWK segment to specify that documents are being submitted in support of the claim and no additional face sheet or coversheet is needed.

 

Here are the steps:

  • Log in to Availity Portal
  • Select Claims & Payments I Attachments - New
  • From the Inbox tab, select the appropriate claim or open the request in your work queue
  • Add files with supporting documentation
  • Submit

 

Get trained

  • Attend an Availity-hosted webinar to learn more about all capabilities. You can register for an upcoming live webinar hosted by Availity here, or
  • Log into availity.com and select Help & Training | Get Trained to open the Availity Learning Center in a new tab (it is your dedicated ALC account).
    • Search by keyword (Medattach) to find on-demand and live training options
    • Click Enroll to enroll for a course and then go to your Dashboard to access it any time

 

Get started today with these wide-ranging capability enhancements to transform your business operations to a quick, secure, paperless and simple process to fulfill medical records requests electronically through Availity.

 

*Unsolicited Attachment: Documentation submitted without a formal request from the payer

*Solicited Attachment: Documentation submitted in response to a specific request from payer

 

1017-0321-PN-GA



Featured In:
March 2021 Anthem Provider News - Georgia