Availity^® Attachments: Submit Predetermination of Benefits Requests Online

Availity’s Attachments tool allows providers to quickly submit predetermination of benefits request online to Blue Cross Blue Shield of Texas (BCBSTX).

A predetermination of benefits is a voluntary request for written verification of benefits prior to rendering services. BCBSTX recommends submitting a predetermination of benefits request if the service may be considered experimental, investigational or unproven, as specified within the BCBSTX Medical Policy.

You must be registered with Availity to use the Attachments tool. You can sign up today at Availity , at no charge. For registration assistance, call Availity Client Services at 800-282-4548.

This information does not apply to requests for Texas Medicaid or Medicare Advantage members.

How to access and use Availity Attachments

1. Log in to Availity
2. Select Claims & Payments from the navigation menu
3. Select Attachments – New
4. Within the tool, select Send Attachment then Predetermination Attachment
5. Download, complete and save the Predetermination Request Form
6. Complete the required data elements
7. Upload the completed form and attach supporting documentation
8. Select Send Attachment(s)

For additional details, refer to the Electronic Predetermination of Benefits User Guide  .

Questions?

Email our Provider Education Consultants. Be sure to include your name, direct contact information, Tax ID and/or billing National Provider Identifier (NPI).

Please note that the fact that a service has been preauthorized/pre-notified, that a guideline is available for any given treatment or that a service or treatment has been predetermined for benefits, 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 BCBSTX. BCBSTX 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.