EDI
PW_038000
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Welcome to Anthem Blue Cross and Blue Shield’s E-Solutions page for the East Region – Connecticut, Maine, and New Hampshire.
Contact Information
E-Solutions
Phone: (800) 334-8262
Hours: 8:00 – 4:30 ET M-F
What is Electronic Data Interchange?
Electronic Data Interchange (EDI) allows providers to submit claims, retrieve claim file acknowledgments and remittance advices from their insurance carrier or clearinghouse electronically.
How many claims do we receive electronically?
Approximately 93% of claims submitted to Anthem are received electronically.
Why submit claims electronically?
 | Electronic claims represent a savings of up to $3.00 per claim by reducing the amount of paperwork |
| Postal delays avoided since electronic claims may be transmitted 24 hours a day, seven days a week |
| Electronic claims are faster and more accurate |
| Anthem acknowledges receipt of electronic claims through notification and error reports, which are placed in your electronic mailbox |
| An electronic remittance advice is offered to all electronic submitters to allow providers to post payments automatically |
What are the Myth Busters about submitting my claims electronically?
Anthem DOES accept claims electronically that will require additional paperwork.
Send us your claim electronically indicating that paperwork will be forthcoming (ask your vendor how to populate the PWK02 in Loop 2300 with BM). Then forward the paperwork by mail using the Attachment Face Sheet available on our website – www.anthem.com/edi.
Anthem DOES accept adjusted or voided claims electronically.
Ask your software vendor how to do these 2 simple steps:
| populate the claim with a frequency type code of 7 (adjustment) or 8 (void) |
| populate the Original Reference Number ICN/DCN in Loop 2300 with the Anthem claim number |
Anthem DOES accept COB claims electronically.
Claims with Anthem as secondary or even tertiary payer are accepted and pay more promptly when submitted electronically. See our Companion Documents for information on populating Loop 2320 – Other Subscriber Information for Coordination of Benefits.
Anthem DOES accept electronic claims for out-of-state Blue Cross Blue Shield plans.
Anthem will accept and forward electronic claims for most of the Blue Cross Blue Shield plans. Simply include these claims within your transmission file and Anthem will route them according to the subscriber’s certificate ID.
Anthem DOES accept all types of claims electronically, including home health claims.
The government mandates of the Health Insurance Portability and Accountability Act require Anthem to accept all claim types electronically. Contact us today for more information.
Anthem DOES provide an immediate acknowledgement of your electronic claims file.
Electronic transactions produce an immediate acknowledgement report, a virtual receipt of your claims. You will also receive a response report listing claim detail and initial entry rejections, which can immediately be corrected and resubmitted.
Anthem DOES have software solutions.
Anthem can provide a list of approved software vendors and clearinghouses.
Which claims may be submitted electronically?
We accept all Institutional and Professional claims, including FEP, National, Medicomp* and BlueCard.
How can I contact EDI Support via Email?
If you're experiencing a problem related to EDI, please request support via this link . EDI.ENT.Support@anthem.com
*NOTE: Since Medicare automatically sends Medicomp claims to Anthem for secondary payment, allow for 30 days for Medicare’s payment or receipt of Explanation of Medicare Benefits (EOMB) prior to submitting Medicomp claims.
What are the Payer Codes for the Northeast 1000B MN109 and 2010BB NM109?
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Maine
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00680
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00180
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ANTHEMXXDENTAL
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New Hampshire
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00770
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00270
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ANTHEMXXDENTAL
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Connecticut
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00060
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00060
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ANTHEMXXDENTAL
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What payer ID code do I use?
If you submit electronic claims/transactions directly to Anthem Blue Cross Blue Shield, please use the applicable code listed above. If you submit through a clearinghouse or use a software vendor, you should check with them for the correct value that should be used. Many clearing agencies use proprietary values therefore we do not assign or maintain payer ID codes for other entities, clearinghouses or vendors.
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