Electronic data interchange (EDI)

EDI lets you:

• Process claims faster by submitting Coordination of Benefits electronically
• Identify and correct errors for clean claim submissions
• Reduce overhead and administrative costs
• Eliminating paper claim submissions
• Speed up enrollment and payment for employer group benefit
• Ensure data security by using Secure File Transfer Protocol (SFTP) or the Availity Essentials website to upload files

HIPAA transaction codes

Care providers can use Availity Essentials to submit the following HIPAA transaction codes:

• 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)
• Medical Attachments (275)

EDI submissions and transactions

Availity makes submissions and transactions easy.

Availity’s EDI submission options:

1. Use existing clearinghouse or billing vendor
   • Work with your vendor to ensure connection to the Availity EDI Gateway
2. Become a direct submitter with the Availity EDI clearinghouse
   • A third-party practice or revenue cycle management system capable of generating EDI batch files is required

Already have an Availity Essentials account but want to submit EDI Transactions?

1. Sign in to Availity Essentials
2.  Select My Providers > choose Enrollments Center > select Transaction Enrollment
3. Follow the steps to enroll as a trading partner

New to Availity and want to submit EDI transactions?

1. Choose an administrator to register your organization
2. Select the register button at the top of the page when the administrator is ready to register
3. Select your organization type and complete the registration process
4. Verify the account using the email sent to the administrator
5. Once verified, the administrator will:
   • Agree to the disclaimer
   • Establish security questions
   • Change password
   • Set up authorized users and permissions

Payer ID

Payer IDs route EDI transactions to the appropriate payer.

Anthem Blue Cross and Blue Shield Healthcare Solutions Payer ID is 000265

Note: If you use a clearinghouse, billing service or vendor, please work with them directly to determine payer ID.

Electronic remittance advice (ERA)

The 835 eliminates the need for paper remittance reconciliation. Use Availity to register and manage ERA account changes with these easy steps:

1.  Log in to Availity Essentials
2. Select My Providers > Enrollment Center > Transaction Enrollment

Note: If you use a clearinghouse or vendor, please work with them on ERA registration and receiving your ERAs.

Electronic funds transfer (EFT)

Electronic claims payment through electronic funds transfer (EFT) is a secure and fast way to receive payment, reducing administrative processes. EFT deposits are assigned a trace number that is matched to the 835 electronic remittance advice (ERA) for simple payment reconciliation.

Use EnrollSafe to register and manage EFT account changes.

Access EnrollSafe 

Contact information

For information on EDI, please refer to your provider manual or sign in to your Availity Essentials account. For any additional questions, contact your Provider Relationship Management Representative or Availity Client Services.

Provider Services

Phone:  1-844-396-2330

Availity Client Services

Phone:  1-800-AVAILITY (282-4548)

EDI resources

Availity EDI Connection Services Startup Guide 

Availity EDI Standard Companion Guide 

Availity Registration Page 

Washington Publishing Company