EDI Transactions

EDI allows providers to access timely information in today’s health care environment. 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.


  • No more paper claim forms
  • No more endless waiting for callbacks
  • No more postage expense
  • No more voicemail or busy signals
  • View and submit prior authorizations, referrals and/or recommended clinical reviews

We offer a variety of multi-payer solutions: 

Electronic Claim Status/Details

Check real-time claim status for our commercial and government claims.

Services Offered:

  • Electronic Explanation of Benefits
  • On-line Claim Status

Electronic Claim Submission/Adjudication

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 and Benefits 

Check our commercial and government payers' members eligibility and benefit coverage at a single location.

Electronic Prior Authorization, Referrals and/or Recommended Clinical Review

Submit and/or view prior authorization, referrals and/or recommended clinical reviews.

For more information on the above electronic solutions benefits, visit Availity® Essentials and get additional details about online resources on the Provider Tools page of our website.

Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSTX.

BCBSTX makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.