Effective November 1, 2022, Blue Cross and Blue Shield of Montana (BCBSMT) implemented its new program with Avalon Health Solutions for claims for certain outpatient laboratory services provided to many of our commercial members in Montana.
Avalon Healthcare Solutions has developed a Trial Claim Advice Tool which allows providers to input the procedure codes and diagnoses to view a preliminary determination of how the claim may be reviewed. Responses consider information entered through the tool for the date of service entered and historical claims finalized through the previous business day. Claims not yet finalized won’t be considered.
- The Trial Claim Advice Tool does not guarantee approval, coverage, or reimbursement of services.
- Responses consider information entered through the tool for the date of service entered and historical claims finalized through the previous business day
How to access the Tool:
- To access the Trial Claim Advice Tool, log on to Availity® Essentials.
- To get to the Trial Claim Advice Tool, use the single sign-on feature via the BCBS-branded Payer Spaces section within the Availity portal
- If you’re not a registered Availity user, register on the Availity website at no charge. For registration help, call Availity Client Services at 800-282-4548.
Additional Resources
Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSMT. BCBSMT makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.