Learn MoreĬlinical Quality Validation (CQV) ApplicationĬlinical Quality Validation (CQV) is a web-based application in the Availity ® Provider Portal that allows providers to quickly comply with Healthcare Effectiveness Data and Information Set (HEDIS ®) measures.
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C3 "mirrors" how BCBSTX's current code auditing software evaluates code combinations during the adjudication of a claim. Learn MoreĬlear Claim Connection (C3) is a web-based code auditing tool, designed by McKesson Information Solutions, Inc., that enables BCBSTX to disclose our claim auditing rules and clinical rationale to our contracting provider network. The Availity ® Claim Status Tool offers enhanced, real-time claim status functionality to help you manage and resolve claims processed by BCBSTX. By providing a method for online assistance with specific inquiries on finalized claims, the CIR tool can help save your staff time by reducing the need for phone calls and written correspondence. Our Claim Inquiry Resolution tool is available via a tab in our Electronic Refund Management (eRM) system. Learn More.įind facilities recognized for expertise in bariatric surgery, cardiac care, complex and rare cancers, knee and hip replacement, spine surgery, and transplants on the Blue Distinction website.
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This free online tool can provide you with co-payment, co-insurance, deductible, and other important information. To obtain fast, efficient, detailed benefits information for Blue Cross and Blue Shield members, you can use Availity's Eligibility and Benefits tool. It is important to verify membership and check coverage details for every patient at every visit, before you administer treatment.
Learn MoreĪuthorizations & Referrals is an online tool in the Availity Provider Portal that allows you to submit prior authorization and/or referral requests handled by Blue Cross and Blue Shield of Texas (BCBSTX).
Whether doing research or streamlining billing, these tools can help you evaluate costs, save time, improve service and more.Īvaility ® Attachments: Submit Predetermination of Benefits Requests OnlineĪttachments is an online tool in the Availity Provider Portal that allows you to submit electronic predetermination of benefits requests handled by Blue Cross Blue Shield of Texas (BCBSTX). We've designed useful tools for health care providers. Refer to the COVID-19 Preparedness page for temporary information related to servicing members in response to COVID-19.Īt Blue Cross and Blue Shield of Texas (BCBSTX), we are committed to providing support to physician practices.
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