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What is Electronic Data Interchange (EDI)?

Electronic Data Interchange (EDI) is the computer-to-computer transfer of transactions and information using a variety of communication methods.  BlueCross BlueShield of Western New York encourages you to submit your claims electronically for improved productivity and cost efficiency.

Below are the electronic tools available for medical providers and administrators to use. 

 

EDI allows medical providers to save time and money, and eliminate delays in claims processing. Medical providers are able to access timely information in today's health care environment. Successful health care organizations are finding ways to automate routine tasks and deploy resources to value added opportunities. 

  • Electronic claims represent an average savings of $1.43 per claim by reducing paperwork, manual intervention, and postage. 
  • Claims can be submitted 24 hours a day, 7 days a week. Eliminating postal delays gets claims processed faster. 
  • BlueCross BlueShield of WNY acknowledges receipt of electronic claims through notification and error reports. 
  • Receive an electronic remittance to allow practices to post payments automatically. 
BlueCross BlueShield of Western New York accepts all types of claims electronically:
  • Professional
  • Institutional
  • Dental
  • Adjustments/Corrected claims (use appropriate frequency code)
  • Coordination of Benefits (COB) (use appropriate indicator)
  • Late charges (use appropriate frequency code)
*Please note, claims requiring attachments cannot be sent electronically at this time. 
 
The electronic Payer ID for BlueCross BlueShield of Western New York is 00801 and is recognized by most clearinghouses and vendors in order to route electronic claims to BlueCross BlueShield of Western New York. You may need to contact your clearinghouse to see if they use a different Payer ID. 
 
To register to submit claims, or for more information about electronic submissions, please visit the Administrative Services of Kansas (ASK) website, www.ask-edi.com and look for the New York customers link. The ASK help desk can also be reached at 1-800-472-6481

 

ERA is an electronic file that explains claim payment and remittance information. The ERA is received after a claim is finalized. The HIPAA compliant format can be automatically posted to your patient accounting system.

EFT is a secure method of claims payment. BlueCross BlueShield of Western New York electronically transfers funds directly into the bank account of your choice for added security and prompt payments. 

Advantages of Electronic Funds Transmission (EFT) and Electronic Remittance Advice (ERA):

  • No more lost or stolen checks
  • Quicker access to your funds
  • Increased security of information
  • Less time spent on claims checking
  • Expedited patient account reconciliation
  • Easier retrieval or archived data
To enroll for ERA:
To enroll for EFT:
  • A registration code is required to complete registration. Registration code is made available on first payment check.
  • Visit the Payspan Health website
  • Complete the online registration form
  • Upon successful registration, a verification email will be sent to complete enrollment

Optimize the delivery of patient information (eligibility, claims status, referrals) to the health care community by leveraging our shared infrastructure, technology, and intellectual capital. HEALTHeNET website. 

 

Provide timely and accurate electronic exchange of clinical information among health care providers and others involved in the delivery of health care services in Western New York. HEALTHeLINK website

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