Electronic claim payment reconsideration
Beginning March 7, 2019, providers will have the ability to submit claim reconsideration requests through the Availity Portal with more robust functionality. For you, this means an enhanced experience when:
- Filing a claim payment reconsideration.
- Sending supporting documentation.
- Checking the status of your claim payment reconsideration.
- Viewing your claim payment reconsideration history.
New Availity Portal functionality will include:
- Acknowledgement of submission at the time of submission.
- Notification when a reconsideration has been finalized by Anthem Blue Cross and Blue Shield Healthcare Solutions.
- A worklist of open submissions to check a reconsideration status.
With the new electronic functionality, when a claim payment reconsideration is submitted through the Availity Portal, we will investigate the request and communicate an outcome through the Availity Portal. Once an outcome has been determined, the Availity Portal user who submitted the claims payment reconsideration will receive notification informing him/her that the reconsideration review has been completed. If you are not satisfied with the reconsideration outcome, continue to follow the existing process to file an appeal, as outlined in your provider manual.
Look for announcements on the Availity Portal for upcoming training opportunities. Providers who have questions as they begin to use the new functionality should contact Provider Services at 1‑844‑396-2330.
January 2019 Anthem Provider Newsletter - NV