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.
Start by reading our Trading Partner Agreement and Authorization: Online claim submission (portal) Frequently asked questions (PDF) and select the option that most closely describes you.
We’re making changes that offer providers a new option for submitting Blue Cross, Medicare Plus BlueSM, Federal Employee Program®, Blue Care Network, BCN AdvantageSM and Blue Cross® Complete claims.
Read more about the transition to the Availity® provider portal.
To become an approved submitter, you must complete these steps:
You must follow these steps:
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