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Setting up a direct connection to us

Can you or your clearinghouse/billing service create and receive HIPAA-compliant 837 and 835 files? If so, you can connect your IT system to ours and use this direct connection—or electronic data interchange—to perform electronic transactions. We encourage all health care providers to submit transactions and receive payments electronically to benefit from:

  • Reduced administrative costs and paperwork for your office
  • Improved accuracy of billing and posting information
  • Better security for protected information
  • Improved cash flow
  • Faster claims processing
  • A dedicated EDI (Electronic Data Interchange) team available to assist help you

We can set up a direct connection with you for these transactions:

EDI transaction Description
835 Claim payment advice (electronic remittance)
837 Health care claims
270/271 Eligibility and benefits
276/277 Claim status
How to get started

If you can create a HIPAA-compliant 837, follow these steps to start submitting transactions directly to Blue Cross Blue Shield of Massachusetts.

If you cannot create a HIPAA-compliant 837, please refer to the following section, "What to do if you use a clearinghouse."

Please note: You don't need to follow these steps if you are contracted with us and would like to submit professional claims using Direct Data Entry (DDE) via Online Services. Go to our Online Services page to learn more about registering for DDE.

Step Email EDIsupport@bcbsma.com to request a Trading Partner Agreement (TPA) and SFTP Account Request Form.

In your email, please include your organization’s legal name and corporate mailing address.

Step Email us the completed forms.
Use the subject line, "Security Forms." NOTE: If you are planning to have more than one user, have all the individuals at your organization who will need manual access to your Tumbleweed EDI mailbox complete the SFTP Account Request Form (sections in brackets). Email us separately.
If you are We will use the data you provide to
A provider who is not going to auto submit files (typically smaller practices or organizations) Grant file transmission privileges. The password for access expires every 90 days.
A provider who will auto submit files (typically larger practices or organizations) Set up your server connection to us within Tumbleweed and will grant file transmission privileges. We recommend that you set up a user account in case system issues occur. The password for access expires every 365 days.
Step Test the system
An EDI analyst will contact you to guide you through the testing process.
Step Begin submitting transactions
After successfully testing and completing the required forms, you can begin submitting transactions directly to Blue Cross Blue Shield of Massachusetts.  
What to do if you use a clearinghouse

We have completed testing and have trading partner agreements in place with many of the major clearinghouses.

If you select and sign a contract with an approved clearinghouse, please have them email a completed EDI Enrollment Form to EDIsupport@bcbsma.com. (They have the form.)

Here’s a list of approved clearinghouses:

  • Abrea Technologies, Inc.
  • Apex EDI
  • Availity, LLC
  • Change Healthcare
  • Claim MD, Inc.
  • ClaimLogic
  • ClaimRemedi
  • ClaimsPro, LLC
  • CompuClaims
  • Cortex EDI
  • CureMD.com, Inc.
  • Data Distributors
  • EDI Health Group, Inc.
  • Electronic Network Systems ENS/Optum
  • Eligible, Inc.
  • Emergent Billing, LLC
  • Encoda, Inc.
  • Experation/Passport Health, Inc.
  • G4 Health Systems, Inc.
  • Gateway EDI, LLC/Trizetto Provider Solutions, Inc.
  • GE Healthcare IITS USA, Corp.
  • Health Care Financial Services, Inc.
  • HMS
  • Infinedi, LLC
  • Instamed Professional
  • Integrated Physicians Management Servcies
  • Laboratory Billing Solutions, Inc.
  • MDOL/Ability Network
  • MedAssets
  • Medical Transcription Billing, Corp (MTBC)
  • MG Squared, Inc.
  • Navicure, Inc.
  • New England Medical
  • Nuesoft Technologies, Inc.
  • Office Ally, LLC
  • Paton Data
  • PHIcure, Inc.
  • Plexus Management Group
  • Practice Insight, LLC
  • Pulse System/Nightingale Vantagemed Corp.
  • Quadax
  • Relay Health
  • Techsoft, Inc.
  • The Consult, Inc.
  • The SSI Group
  • TKSoftware, Inc.
  • Trizetto NEHEN
  • ViaTrack Systems
  • XIFIN, Inc.
  • Zirmed, Inc.
Companion Guides and other resources

These guides and resources can help you with your electronic transactions. Make sure you access the latest version of these guides. Revisions we make are noted on the last page of each document.

Use this resource To
Learn specific data content for electronic transactions with Blue Cross Blue Shield of Massachusetts
Access CAS, claim status and other codes lists.
Technical questions

Contact our EDI Production Support team:

Email: EDISupport@bcbsma.com

Phone: 1-800-771-4097 (Available Monday-Friday, 8 a.m. - 4 p.m.)