Dec. 15, 2020
In the August News and Updates, we introduced a new online tool via Availity called Patient ID Finder. This tool allows you to quickly obtain a Blue Cross and Blue Shield of Montana (BCBSMT) patient’s insurance ID and group numbers after entering patient-specific data elements
We are excited to announce that you can now use the Patient ID Finder to obtain the insurance ID and group numbers for Medicare Advantage.
How do you use the Patient ID Finder via Availity?
Searching online for BCBSMT patient ID number is easy and consists of only four steps:
- Log into Availity
- Select Payer Spaces from the navigation menu and choose BCBSMT
- Select Patient ID Finder from the Applications tab, then complete and submit the request
- Patient ID and group numbers are returned
Note: This tool does not reflect the patient's eligibility or benefits. Refer to the Eligibility and Benefits User Guide for assistance with obtaining real-time eligibility and benefits information via Availity.
Providers not yet registered with Availity can sign up today at Availity, at no charge. For registration assistance call Availity Client Services at 800-282-4548.
For More Information
- Refer to the Patient ID Finder User Guide in the Provider Tools section of our website.
- Visit the Training page on our website to register for an upcoming Availity 101 session hosted weekly to learn more about online offerings, including the Patient ID Finder.
- If you need further assistance or customized training, contact our Provider Education Consultants.
Checking eligibility and/or benefit information and/or the fact that a service has been preauthorized is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage applicable on the date services were rendered. If you have any questions, call the number on the member’s ID card.
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 any products or services provided by third party vendors such as Availity. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.
If you participate in Blue Cross Medicare AdvantageSM plans, you may not bill our members enrolled in QMB, a federal Medicare savings program
QMB patients are dual eligible beneficiaries, which means they are eligible for both Medicare and Medicaid. As a state Medicaid benefit, QMB covers the Medicare Advantage premiums, deductibles, coinsurance and copayments of QMB beneficiaries. QMB beneficiaries are not responsible for Medicare Advantage cost-sharing, or out-of-pocket costs.
For services you provide to QMB patients, you must:
- Bill both Medicare Advantage and Medicaid
- Accept Medicare Advantage payments and any Medicaid payments as payment in full
Tips to avoid billing QMB patients
Please ensure that you and your staff are aware of the federal billing law and policies governing QMB. It is against federal law for any Medicare provider to bill QMB patients, whether or not the provider accepts Medicaid. Per your Medicare Provider Agreement, you may be sanctioned if you inappropriately bill QMB patients for Medicare Advantage cost-sharing.
To avoid billing QMB patients, please take these precautions:
- Understand the Medicare Advantage cost-sharing billing process
- Be sure your billing software and staff remove QMB patients from Medicare Advantage cost-sharing billing and related collections efforts
Questions?
Call Customer Service at 1-877-774-8592 to learn more about QMB procedures and ways to identify QMB patients. For more details about QMB, see the Centers for Medicare & Medicaid Services website.
The information provided here is only intended to be a summary of the law that has been enacted and is not intended to be an exhaustive description of the law or a legal opinion of such law. If you have any questions regarding the law mentioned here, you should consult with your legal advisor.