Claims overview

Filing your claims should be simple. That’s why Healthy Blue uses Availity, a secure and full-service web portal that offers a claims clearinghouse and real-time transactions at no charge to healthcare professionals. Use Availity to submit and check the status of all your claims and much more.

Don’t have an Availity account?

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Healthy Blue Dual Special Needs Plan (D-SNP)

The Healthy Blue Dual Special Needs Plan (D-SNP) offers a variety of benefits designed to help keep your patients healthy while protecting them from unexpected costs.

Electronic data interchange (EDI)

Electronic data interchange (EDI) is the computer-to-computer exchange of business documents in a structured format. EDI provides a faster and cleaner method for delivering time-dependent data, saving you time compared to filing paper claims.

Provider disputes

You have the right to request an appeal of a claim decision. You may request this appeal on your own behalf or on behalf of a covered Individual.

Reimbursement policies

Policies outlining the basic terms for reimbursement of services covered under our members’ benefits plans. Also, definitions for terms used in the policies and disclaimer for the policies’ use.

Related information

Provider tools & resources

Interested in becoming a provider in our network?

We look forward to working with you to provide quality services to our members.