Don’t forget to update your Provider Authorization Form when changes occur with your 835 (ERA) routing destination

Blue Cross Blue Shield of Michigan is dedicated to safeguarding the protected health information of our members. These safeguards include completion of a Trading Partner Agreement and Provider Authorization Form as part of the electronic data interchange process. All EDI trading partners must complete a TPA and Provider Authorization Form before they can exchange PHI with Blue Cross.

Terms of the TPA require you to notify us of any changes in your trading partner information. You must update your Provider Authorization Form if you send claims using a different submitter ID or route your 835s (Electronic Remittance Advice) to a unique receiver/Trading Partner ID. Updating the form ensures information is routed to the appropriate destination.

Any time you switch vendors, billing services or clearinghouses, you need to update your Provider Authorization Form. To make changes to your EDI setup, follow these steps:

• Visit bcbsm.com/providers.
• Click on Quick Links.
• Click on Electronic Connectivity EDI.
• Click on How to use EDI to exchange information with us electronically.
• Under EDI agreements, click on Update your Provider Authorization Form.

You should review the information on your Provider Authorization Form if you’ve:

• Joined a new group practice
• Left a group practice and now bill using your own NPI
• Hired a new billing service
• Started submitting claims through a clearinghouse or you’ve changed clearinghouses
• Decided you no longer want to receive 835 (ERA) files
• Selected a new destination for your 835 (ERA) files

If you have questions about EDI enrollment, contact the EDI help desk at 1-800-542-0945. For assistance with TPA and Provider Authorization forms, select the TPA option.