Access Eligibility, Claims Status, and Health Care Service Review Capabilities for BlueCard and FEP Members
Coinciding with the October 16, 2003 implementation of the Transactions and Code Sets Rule of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Anthem is participating in a new program across all Blue Cross and Blue Shield (BCBS) plans called BlueExchange.
BlueExchange allows Anthem providers to access patient information electronically, regardless of which BCBS plan houses the membership information.
Providers will be able to submit eligibility, claim status, and health care service review requests for any Blue Cross and Blue Shield or FEP member, through the existing electronic provider self service tools provided by Anthem - including Electronic Data Interchange (EDI) and Anthem’s web based provider self service tools (refer to chart). Each of these transactions must be conducted in a standard HIPAA compliant format.
Electronic Data Interchange
Anthem Online Provider Services
(Web based provider self service)
Eligibility Inquiry and Response (270/271)
Claim Status Inquiry and Response (276/277)
Available for Anthem East members
Referral Request/Authorization Request (278)
Not Currently Available
Anthem providers who are interested in these services are advised to contact their Provider Relations representative to find out more about the exact options available in their service area.
For Frequently Asked Questions about BlueExchange, click here.