Tuesday, 25 October 2016

EDI - Insurance eligibility verification

Electronic Data Interchange (EDI)

Providers can decrease paperwork and increase operating efficiency with Electronic Data Interchange (EDI). EDI is the fastest, most efficient way to exchange eligibility information, payment information and claims. Blue Cross’ experienced EDI staff is ready to assist in determining the best electronic solution for your needs.

iLinkBLUE Provider Suite

iLinkBLUE Provider Suite is a free provider tool that allows providers to verify members’ eligibility, coinsurance and deductible information, file claims electronically, check claims status, and more from an Internet connection. iLinkBLUE features more than 30 applications and allows
providers to have immediate access to Blue Cross member, claims and authorization data from any Internet-ready desktop using Internet Explorer version 8 or higher. iLinkblue users can:

• Verify eligibility and benefit coverage.
• Verify dollar amounts remaining for deductible and out-of-pocket expenses. (This information is updated daily).
• Electronically submit CMS-1500 and UB-04 claims for Louisiana members, FEP members and out-of-state members.
• Submit and receive pre-authorizations for Imaging Authorizations.
• Submit claim inquiries electronically using our “Action Request” functionality.
• Review outstanding Medical Record Requests for out of area members.
• Obtain status of paid, rejected and pending claims and authorization verification.
• View and print current accepted/not accepted claims reports.
• View and print Payment Registers and Electronic Funds Transfer information on Monday of each week.
• View allowable charges online.
• Access various manuals, BlueCard out of area network information, and medical policy guidelines.
• Check the iLinkBLUE message board often for added features, news and important notices.

1 comment:

  1. Our Payer Gatewayplus Portal is a cut above the rest. Other companies offer rudimentary patient medicare eligibility verification solutions that simply do not compare to ours.


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