Oct. 20, 2025
To help ensure that claims are processed accurately and efficiently, we encourage you to review the billing guidelines in the Claim Filing and Claim Submission section of our Commercial Provider Manual.
Here’s a brief checklist for filing claims:
- Check eligibility and benefits prior to rendering services using Availity® Essentials or your preferred vendor, or call the number on the member’s ID if you have questions
- Verify the member ID
- Use proper billing codes
- Consult medical policies and verify accepted status of new procedures
- Check patient history
- Check or audit billing services
Resources
- Review our Medical Policies and Clinical Payment and Coding Policies
- Refer to our Commercial Provider Manual and BlueCard® Program Provider Manual
- Check our Education and Reference Center for news, tools and webinars on filing claims.
The information provided does not constitute coding or legal advice. Physicians and other health care providers should use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment, and to submit claims using the most appropriate code(s) based upon the medical record documentation, coding guidelines and reference materials.