EDI Registration Form - Empire Blue Cross Blue Shield 2025

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The document is an EDI Registration Form for Empire BlueCross BlueShield, requiring completion of various sections to register for electronic data interchange services. It includes options for actions such as adding, changing, or deleting information, specifies the line of business and EDI transactions applicable, and outlines network connectivity and file transfer methods. Additionally, it collects trading partner information and emphasizes the provider's responsibility for data handling.

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Click ‘Get Form’ to open the EDI Registration Form in our platform.
Begin with Section I, where you will need to select an action: Add, Change, or Delete. Ensure you choose the appropriate option based on your needs.
In Section II, select your Line of Business from options like BlueCross, BlueShield, or Commercial. Then check all applicable EDI Transactions such as 837 Claim or 835 Remittance.
Proceed to Section IV and choose your Network Connectivity method. This is crucial for ensuring proper communication with Empire.
In Section V, select your preferred File Transfer Method. Options include HTTPS Batch Upload or Secure SFTP; make sure to choose one that fits your operational capabilities.
Fill out Section VI with Trading Partner/Submitter/Receiver Information. If you're a new submitter, leave the Submitter ID field blank.
Complete Sections VII and VIII if applicable, providing Software Vendor Information and Provider Information respectively. Review the Companion Guide for additional details.

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Versions	Form popularity	Fillable & printable
2022	4.8 Satisfied (55 Votes)
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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is an EDI number for insurance?

EDI (Electronic Data Interchange) X12 is a data format based on the Accredited Standards Committee (ASC) X12 standards. The Implementation Guides adopted under the Health Insurance Portability and Accountability Act (HIPAA) can be found at - edi.com/.

What is bcbs edi?

Electronic transactions are exchanged through an approved Electronic Data Interchange (EDI) clearinghouse or with Blue Shield of California directly through secure file transfer protocol. Companion Guides for Blue Shield and Blue Shield Promise Health Plan are available for download at EDI Companion Guide.

Does Blue Cross Blue Shield have a payer ID?

Empire will consider reimbursement for the initial claim, when received and accepted within timely filing requirements, in compliance with federal, and/or state mandates. Empire follows the standard of: 90 days for participating providers and facilities. 15 months for nonparticipating providers and facilities.

What is an example of an EDI payment?

The Payer ID or EDI is a unique ID assigned to each insurance company. It allows provider and payer systems to talk to one another to verify eligibility, benefits and submit claims. The payer ID is generally five characters, but it may be longer.

What does EDI mean for insurance?

3 Examples of EDI Payments Relevant documents include invoices, purchase orders, shipping notices, billing statements, customer orders, bills of lading, and customs documents.

empire blue forms

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Are Empire BCBS and BCBS the same?

As of January 1, 2024, the Empire BlueCross BlueShield and Empire BlueCross names are Anthem Blue Cross and Blue Shield and Anthem Blue Cross. This will not impact your coverage, access to care, or level of support. Want to know more about Anthem?