EDI Transactions

EDI allows Medical Providers 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 valued added opportunities.

EDI shortens the time to send and receive health care claims information. It allows you to view, track, and monitor claim status reports electronically.

Imagine:

  • No more claim forms
  • No more endless waiting for callbacks
  • No more postage expense
  • No more voicemail or busy signals
  • View and Submit Precertifications

Electronic Claim Status/Details

BCBSTX offers a variety of multi-payer solutions to check claim status on BCBSTX and other commercial and government claims.

Services Offered:

  • Electronic Explanation of Benefits
  • On-line Claim Status

Electronic Claim Submission/Adjudication

BCBSTX offers a variety of multi-payer solutions to submit and/or adjudicate claims real-time or in batch.

  • ANSI x12 837 Claims Transmission (Institutional and Professional)
  • Electronic Remittance Advice
  • Electronic Funds Transfer
  • Electronic Reports on Transactions

Electronic Eligibility Verification

BCBSTX offers a variety of multi-payer solutions to verify BCBSTX and other commercial and government payers' members eligibility at a single location.

  • Online Membership and Eligibility

Electronic Pre-Certification

BCBSTX offers a variety of multi-payer solutions to submit and/or view pre-certifications.

For more information on the above electronic solutions benefits, feel free to click on any of the following Web sites: