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:
We can set up a direct connection with you for these transactions:
|835||Claim payment advice (electronic remittance)|
|837||Health care claims|
|270/271||Eligibility and benefits|
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.
|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.
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:
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.|