EDI transitioning to Availity starting in 2023

Blue Cross Blue Shield of Michigan and Blue Care Network will move our electronic data interchange services, known as EDI, to Availity^® beginning in August 2023.

The EDI transition affects HIPAA electronic transactions. The transition will occur in phases, starting with claims (837) and remittance (835) transactions, but all electronic transactions will transition to Availity. Examples of electronic transactions include the electronic 837 claims, 835 electronic remittance advice, 270/271 eligibility and benefit, 276/277 claim status and 278 prior authorizations.

This transition includes electronic transactions for all Blue Cross and BCN fully insured and self-funded health plans. This includes:

• Blue Cross commercial, including the Federal Employee Program^®
• Medicare Plus Blue℠, our Medicare Advantage PPO plan
• Blue Care Network commercial
• BCN Advantage℠, our Medicare Advantage HMO and POS plans
• Blue Cross^® Complete

If you submit HIPAA EDI transactions to Blue Cross for payers other than Blue Cross and BCN and our health plans listed above, you’ll need to find a new method to submit those transactions. Blue Cross Blue Shield of Michigan EDI will no longer accept non-Blue Cross and BCN health plan transactions once our EDI transitions to Availity.

Many of our EDI submitters and trading partners already submit to Availity’s EDI clearinghouse for other health plans. In 2022, Blue Cross and BCN moved our provider portal to Availity’s secure platform where you can find information for members associated with multiple health plans.

We expect the EDI transition to begin in August 2023.

Availity will handle all transition activities and will start sending communications to our EDI submitters and trading partners 90 to 120 days prior to the transition.

• If you use a submitter or trading partner to exchange electronic transactions with us, check with them to ensure they’re working with Availity on this transition.

• If you currently submit HIPAA EDI transactions today directly to Blue Cross and believe we may not have your most up-to-date email on file, reach out to partnermanagement@availity.com to update your contact information.

If you have any questions about the EDI transition, send an email to partnermanagement@availity.com. Don’t contact Blue Cross EDI.

Availity is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to offer provider portal and electronic data interchange services.