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FAQs - Provider Services

Claims information is available through on-line claim status for how long?
Approximately 18 months.
Does the BCBSKS Web site furnish claim status and eligibility information about local BCBSKS members and out-of-area BCBS members?

In most cases yes and access for both local and out-of-area information is through the same “secured services” section of the BCBSKS Web site. Most of the same online screens that you use for inquiries about local members are used to obtain information for out-of area members however some additional information is required.

After you “submit” an inquiry for an out-of-area member, our system will access and retrieve the information from the other BCBS plan. Response time may take up to 50 seconds.

For complete details about online claim status and eligibility for out-of-area members, see our November 22, 2005 newsletter.

NOTE: Some BCBS plans do not offer online inquiry services. If a Kansas provider uses the BCBSKS online system to inquire about an out-of-area member and if the member’s home plan does not offer online inquiry the following message (or something similar) will be returned:
"CANNOT PROCESS.  ENTITY NOT REAL TIME.  RESUBMIT BATCH".

When using the online inquiry functions, should the member’s identification number include the three-character alpha prefix*?

Yes. The alpha prefix is considered part of the identification number and should always be included. The alpha prefix is used to determine if your inquiry is about a local BCBSKS member or an out-of-area member.

*Federal Employee Program subscribers are identified by a single character alpha prefix of “R”.

Is claim status and eligibility information for Federal Employee Program (FEP) subscribers available on the BCBSKS Web site?
FEP subscribers are considered out-of-area members and are identified by their ID number that begins with a single character alpha prefix “R”. Claim status and eligibility information is available for FEP members just as it is for other out-of-area Blue Plan members.
Can I use the online claim status screens to find out information about Medicare claims?
No, the BCBSKS online claim status feature does not include information about Medicare claim.
I need to find out if a specific service is covered under a member’s contract. Is that information available online?
Yes, when using the online eligibility inquiry, providers choose the service type that they want to receive information about. For complete details, see our March 13, 2007 newsletter titled Enhanced Eligibility Inquiry Process. If, after reviewing the available online information you still require additional details you can call:
BlueCard Program
-benefits and eligibility for out-of-area members		 1-800-676-BLUE (2583)
BCBSKS Provider Benefit Line
-benefits and eligibility for Kansas members		 1-800-432-0272
After reviewing the Web eligibility or claim status information, whom do I call if I have additional questions?
For more information contact:
BlueCard Program
-benefits and eligibility for out-of-area members 		1-800-676-BLUE (2583)
BlueCard Program
-claim inquiries for out-of-area members		 1-800-432-3990 ext. 4058
Provider Benefit Line
-benefits and eligibility for Kansas members		 1-800-432-0272
BCBSKS customer service center
-claim inquiries for Kansas members		 1-800-432-3990
What is the BCBSKS interactive voice response (IVR) system and how does it work?

Anytime a provider calls the BCBSKS customer service center or precertification department, the call will be handled by our interactive voice response system. The IVR uses an exchange of spoken information between the person calling and the system to authenticate provider telephone calls and furnish information about claim status and eligibility. At the end of either a claim status or eligibility IVR exchange, the caller can furnish a fax number and a recap of the information will be faxed to them.

Complete IVR instructions are included in our September 12, 2005 newsletter.

What hours are the BCBSKS Web site and IVR system available for use?

This question is more easily answered by telling you when they’re not available. They are not available Sundays from 6:00 p.m. to midnight central time.

If you’re using the BCBSKS Web site for out-of-area claim status or eligibility inquiries, please know that some plans do not offer online inquiry capabilities from 12 midnight to 6 a.m. If you try to use the online system and the other plan isn’t up, you’ll get a message: "CANNOT PROCESS. ENTITY NOT REAL TIME. RESUBMIT BATCH"

BCBSKS is encouraging providers to rely on the Web based remittance advice (RA) process to receive their payment information. What are the advantages to “shutting off” the paper RA?

Some of the advantages of Web based RAs are:

  • Search function (patient name, ID, account number, etc.)
  • Enlarge the print size
  • Quickly locate information (scrolling)
  • Receive the RA quicker
  • Eliminates paper (you can still print a copy if needed, and
  • Saves space – save the RA to your system or to a CD.

NOTE: If you have multiple provider numbers, please “shut off” the paper RA for each number.

How can I find out more information about using secured services through the BCBSKS Web site?
Located in the BlueAccess box on the left side of our home page www.bcbsks.com is a “BlueAccess Tour”. This tour explains how to access and use the secured information located on the BCBSKS Web site including how to establish a provider profile.

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