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.
- 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.
- 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.
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.
- Learn more about products and services by visiting the Nebo Systems website.
- Enroll for NDAS Online/eCare. Sign Up Now!
- Already a registered user? Go to the eCare log in page.
- 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”!
- 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.
- Contact your software vendor, billing service, clearinghouse if you have any questions about the services they provide.
- Contact our E-Commerce Center at 800-746-4614 for additional assistance regarding EDI transaction issues.