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We want to make it easy for you to do business with us. This means providing you with online Health Information Technology resources and options that can help you streamline your administrative processes.

 

Electronic Data Interchange (EDI) Transactions

The fastest way to conduct business with BCBSIL throughout the entire claims process is via Electronic Data Interchange (EDI)—the computer-to-computer transmission of standardized information. EDI transactions are often identified by numbers assigned by the American National Standards Institute (ANSI). Here are some examples:

  • Eligibility & benefits inquiry/response (ANSI 270/271)
  • Referrals, pre-certification and authorizations (ANSI 278)
  • Electronic claim submission (also known as Electronic Media Claims, or EMC) [ANSI 837P (Professional) or ANSI 837I (Institutional)]
  • Claim status request/response (ANSI 276/277)
  • Claim payment via Electronic Funds Transfer (EFT)
  • Electronic Remittance Advice (ERA), or delivery of claims payment information (also known as ANSI 835)

Online Transaction Schedule

Effective Jan. 1, 2013, online Eligibility & Benefits (270/271) and Claims Status (276/277) transactions may be conducted almost continuously, with the exception of Sunday, 8 p.m. to midnight, CT.*

  

*Non-routine downtime will be communicated via designated third party independent vendor websites at least one week in advance.




  1. Establish a vendor connection. Some electronic transactions, such as EFT, may be set up directly with BCBSIL. For other EDI transactions, you will need to enlist the services of a third-party electronic business vendor. See the E-Commerce Connections menu below for more details.
  2. Follow standards and guidelines. When conducting EDI transactions, health care providers, billing agents and clearinghouses must follow Health Insurance Portability and Accountability Act (HIPAA) standards. Visit our HIPAA Regulations and Implementation Guidelines page for more details.

How can you streamline your administrative processes? The answer is simple: Electronic Data Interchange (EDI) transactions. See below for a list of multi-payer vendor portals that can help provide a secure electronic gateway between your office and BCBSIL for the exchange of real-time member/claim-related health care data.

 

Availity®

To register with Availity or learn more about services available to BCBSIL providers, visit the Availity website,  or call Availity Client Services at 800-AVAILITY (282-4548).

 

NDAS Online (eCare®)

Network Data Access Services (NDAS) Online is available to BCBSIL contracted providers through Passport/Nebo Systems.

 

RealMed®

To register with RealMed or learn more about services available to BCBSIL providers, visit the RealMed website,  or call the RealMed Customer Service Center at 877-REALMED (732-5633)

 

Reminders:

  • Prior to conducting Electronic Data Interchange (EDI) transactions, you will need to confirm services are available and register with your selected vendor.
  • In some cases there may be a fee for services. We encourage you to “shop around”!

Additional Resources

  • To learn more about your electronic options at BCBSIL, visit our online Education and Reference Center for dates and times of upcoming Workshops and Webinars.
  • If you have questions that cannot be answered by your clearinghouse or software vendor, you may contact our Electronic Commerce Center at 800-746-4614 for assistance.

E-Commerce Alerts provide notification of system enhancements, upgrades, new functionality, and any Electronic Data Interchange (EDI) transaction issues that may affect claims processing, payment or remittance delivery. This includes system downtime alerts, edit/automatic error code implementation notices, and Warning ("W") / Rejection ("R") status changes.

 

Holiday Schedule Reminders 

Availity Webinars 

 

Alerts 


Blue Cross and Blue Shield of Illinois (BCBSIL) supports File Transfer Protocol (FTP) via an Internet connection using PGP encryption. FTP is an industry standard protocol that allows for the transmission of data between systems of varying types using an internet connection. If you do not have PGP encryption software, you may purchase it here.

 

If you are interested in transmitting or receiving files via internet FTP, you must first become a BCBSIL electronic partner. After you receive your BCBSIL assigned identification number, you will need to complete the FTP Activation Form. Please send your public key to HCSC FTP Membership.

 

The key that you send can not be the HCSC public key. You must send a public key created through the use of your PGP encryption software. This is the encryption key that BCBS will use to encrypt all the files loaded to your mailbox.

 

For additional information regarding FTP, please review our FTP Instructions.

 

What is the HCSC Public Key?

Before you can send BCBS any file via FTP, you will need to download the HCSC public key. You must encrypt all files that you send to BCBS via FTP with our HCSC public key. To download the HCSC Public Key, simply right click on the link below, select 'Save Target As…' and save it in a location you will remember.

 

HCSC Public Key (2 KB)


  1. Contact your software vendor, billing service, clearinghouse if you have any questions about the services they provide.
  2. Contact our E-Commerce Center at 800-746-4614 for additional assistance regarding EDI transaction issues.

Availity is a registered trademark of Availity, L.L.C. eCare is the registered trademark of Nebo Systems. RealMed is a registered trademark of RealMed Corporation. Availity, L.L.C., Nebo Systems, and RealMed Corporation are independent vendors and are solely responsible for their products and services. BCBSIL makes no representations or warranties regarding any of these vendors.

Verification of eligibility and/or or benefit information is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage applicable on the date services were rendered.