Claims submissions and disputes
Wellpoint uses Availity, a secure, full-service web portal that offers a claims clearinghouse and real-time transactions at no charge to healthcare professionals. Use Availity to submit claims, check the status of all your claims, appeal a claim decision, report a member’s pregnancy, and much more.
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Finding claims tools on Availity
Submit claims
- From the Availity home page, select Claims & Payments from the top navigation.
- Select Type of Claim from the drop-down menu.
Claims status inquiry
- From the Availity home page, select Claims & Payments from the top navigation.
- Select Claims Status Inquiry from the drop-down menu.
Claims dispute
To check claims status or dispute a claim:
- From the Availity home page, select Claims & Payments from the top navigation.
- Select Claim Status Inquiry from the drop-down menu.
- Submit an inquiry and review the Claims Status Detail page.
- If the claim is denied or final, there will be an option to dispute the claim. Select Dispute the Claim to begin the process. You'll be redirected to the Payer site to complete the submission.
Clear Claims Connection
To use Clear Claims Connection:
- From the Availity home page, select Payer Spaces from the top navigation.
- Select the health plan.
- From the Payer Spaces home page, select the Applications tab.
- Select the Clear Claims Connection tile.
Related information
For a complete guide to the Provider Claim Payment Dispute Process, please refer to the provider manual.
Documents
Emergency Room Autopay List of Diagnosis Codes
Facilities Emergency Department Policy
Provider Complaints and Payment Disputes
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