EDI, or electronic data interchange, is a way to exchange information with us electronically. The information can be things like claims, electronic enrollment, patient eligibility and claims status transactions.
You'll need to get set up and follow some guidelines to send and receive information using EDI. We'll help you do that here. You'll also find lists of claims that can't be processed electronically and a library with helpful documents.
For claim submission and receipt of electronic remittance, please read these documents:
Blue Cross EDI is no longer requiring providers submitting through Availity (the new EDI clearinghouse gateway) to complete a Blue Cross EDI Trading Partner Agreement or Authorization. Check with your biller, clearinghouse, service bureau, or vendor before completing a trading partner agreement and/or authorization to check if it's still needed.
Blue Cross EDI no longer requires completion of a Trading Partner Agreement or Provider Authorization for providers to use this service.
If you are a Blue Cross registered provider, please work with an Availity Client Services representative at 1-800-282-4548 (1-800-AVAILITY) for assistance with enrolling and navigating Availity DDE claim submission.
To submit pharmacy claims, you should be set up to bill the pharmacy provider. For technical requirements and instructions, please call one of these numbers:
PPO plans - 1-855-811-2223
BCN plans - 1-844-642-9087