Claims submissions and disputes

 

Tools and instructions for accessing, submitting, and disputing claims

Use Availity for all your claim needs

 

Wellpoint District of Columbia, Inc. uses Availity Essentials*, a secure, full-service website that offers a claims clearinghouse and real-time transactions at no charge to healthcare professionals. Use Availity Essentials to submit claims, check the status of your claims, appeal a claim decision, and much more.

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Finding claims tools on Availity Essentials

 

Submit claims

  1. From the Availity Essentials home page, select Claims & Payments from the top navigation.
  2. Select Type of claim from the drop-down menu.

 

Claims status inquiry

  1. From the Availity Essentials home page, select Claims & Payments from the top navigation.
  2. Select Claim Status Inquiry from the drop-down menu.

 

Claims dispute

 

To check claims status or dispute a claim:

  1. From the Availity Essentials home page, select Claims & Payments from the top navigation.
  2. Select Claim Status Inquiry from the drop-down menu.
  3. Submit an inquiry and review the Claims Status Detail page.
  4. 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 will be redirected to the Payer site to complete the submission.

 

Clear Claims Connection

 

To use Clear Claims Connection:

  1. From the Availity Essentials home page, select Payer Spaces from the top navigation.
  2. Select the health plan.
  3. From the Payer Spaces home page, select the Applications tab.
  4. Select the Clear Claims Connection tile.

 

 

 

Related Resources

 

Prior authorization lookup tool 

 

Prior Authorization forms 

 

Interested in becoming a provider in the Wellpoint District of Columbia network?

 

We look forward to working with you to provide quality service for our enrollees.

 

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