Claims submissions and disputes

Wellpoint uses Availity, a secure, full-service web portal that offers a claims clearinghouse and real-time transactions at no charge to healthcare professionals. Use Availity to submit claims, check the status of all your claims, appeal a claim decision, report a member’s pregnancy, and much more.

Don’t have an Availity account?

Finding claims tools on Availity

Submit claims

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

Claims dispute

To check claims status or dispute a claim:

1. From the Availity 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'll be redirected to the Payer site to complete the submission.

Clear Claims Connection

To use Clear Claims Connection:

1. From the Availity 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 information

For a complete guide to the Provider Claim Payment Dispute Process, please refer to the provider manual.

• Emergency Room Autopay List of Diagnosis Codes
• Facilities Emergency Department Policy
• Provider Complaints and Payment Disputes

Provider tools & resources

• Log in to Availity
• Launch Provider Learning Hub
• Learn about Availity
• Precertification Lookup Tool
• Prior Authorization Requirements
• Claims Overview
• Member Eligibility & Pharmacy Overview
• Provider Manuals and Guides
• Referrals
• Forms
• Training Academy
• Pharmacy Information
• Electronic Data Interchange (EDI)

Interested in becoming a provider in the Wellpoint network?

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

Wellpoint members in the Medicaid Rural Service Area and the STAR Kids program are served by Wellpoint Insurance Company; all other Wellpoint members in Texas are served by Wellpoint Texas, Inc.

Wellpoint STAR+PLUS MMP (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Texas Medicaid to provide benefits of both programs to enrollees.

Coverage provided by Wellpoint, Inc.

Availity, LLC is an independent company providing administrative support services on behalf of Wellpoint.