What is Electronic Data Interchange?
Electronic Data Interchange (EDI) allows providers to submit claims, retrieve remittance advices and retrieve claim file acknowledgements from their computer systems via modem and phone lines to the insurance carrier or clearinghouse.
Why submit claims electronically?
- Electronic claims are not subject to postal delays.
- Claims may be transmitted 24 hours a day and seven days a week.
- Electronic claims are faster and more accurate.
- Electronic claims are acknowledged by BlueChoice HealthPlan through notification and error reports, which are placed in your electronic mailbox.
- Electronic remittance advice is offered to all electronic submitters. This provides a cost savings and allows the provider to post payments automatically.
- The EDI Solutions department is available Monday, Tuesday, Wednesday, Friday 8:00-11:30 a.m., 12:30-5:30 p.m. and Thursday 8:00-9:00 a.m., 10:00-11:30 a.m. and 12:30-5:30 p.m. (EST). For support, call (800) 470-9630.
What are the Payer/Receiver Codes for BlueChoice HealthPlan?
South Carolina Professional: 00403
South Carolina Institutional: 00403
How many claims do we receive electronically?
Approximately 83 percent of claims are received electronically.