Electronic Data Interchange (EDI)
Healthy Blue uses Availity as its exclusive partner for managing all electronic data interchange (EDI) transactions. EDI, including electronic remittance advices (ERA) and electronic funds transfers (EFT), allows for a faster, more efficient and cost-effective way for providers and employers to do business.
EDI lets you:
- Process claims faster by submitting coordination of benefits electronically and fixing errors early with in-system notification and correction.
- Reduce overhead and administrative costs by eliminating paper claim submissions.
- Speed up enrollment and payment for employer groups benefits.
- Upload files through File Transfer Protocol (FTP) or directly in Availity as a batch or single claim submission.
In Healthy Blue’s Availity, you can complete the following HIPAA transactions:
- Healthcare Claim: Professional (837P)
- Healthcare Claim: Institutional (837I)
- Healthcare Claim: Dental (837D)
- Healthcare Eligibility Benefit Inquiry and Response (270/271)
- Healthcare Services Prior Authorization (278)
- Healthcare Services Inpatient Admission and Discharge Notification (278N)
- Healthcare Claim Payment/Advice (835)
- Healthcare Claim Status Request and Response (276/277)
- Payroll Deducted and Other Group Premium Payment for Insurance Products (820)
- Benefit Enrollment and Maintenance (834)
- Medical Attachments (275)
Ways you can use EDI with Availity
Availity’s EDI submission options:
- EDI Clearinghouse for Direct Submitters
Or use your existing clearinghouse vendor:
- Work with your vendor to ensure connection to the Availity EDI Gateway
Payer IDs route EDI transactions to the appropriate payer.
Healthy Blue payer ID: 00544
Note: If you use a clearinghouse, billing service or vendor, please work with them directly to determine payer ID. These may be different when submitting Healthy Blue electronic data interchanges in Availity.
Electronic Remittance Advice (835)
Use Availity to register and manage ERA account changes with these three easy steps:
- Log into Availity.
- Select My Providers.
- Click on Enrollment Center and select Transaction Enrollment.
Note: If you use a clearinghouse, billing service or vendor, please work with them on ERA registration.
Electronic Funds Transfer (EFT)
Use the EnrollHub™, a CAQH Solutions™ enrollment tool, to register and manage EFT account changes.
EnrollHub™ makes it easy for you to handle multiple payers at once, reducing administrative time and costs.
Electronic Data Interchange Trading Partner
The trading partner such as clearinghouse, billing company and vendor connects with Availity’s EDI Gateway to send and receive EDI transmissions easily.
Already have an Availity login but want to submit EDI transactions?
- Log into Availity.
- Click My Providers then select Enrollments Center then select Transaction Enrollment.
- Follow the steps to enroll as a trading partner.
New to Availity and want to submit EDI transactions?
- Make sure there is an Administrator chosen to register your organization, make any updates and set up authorized users.
- Visit Availity's Welcome Application Wizard to walk you through registration and assist with any questions you might have.
- If you are ready to register, choose the register option on the top of the page.
- Select your organization type and complete the registration process.
- Check your email to verify your account.
- Once your account is verified, agree to the disclaimer, set up your security questions, and change your password.
Please contact Availity Client Services with any questions at 1-800-Availity (1-800-282-4548) Monday to Friday, 8 a.m. to 8 p.m. CT.