- Business Transformation
- Policies & Guidelines
Claims and Billing
- National Provider Identifier (NPI)
- Electronic Data Interchange (EDI)
- Claims Requirements and Communications
- Claims Submission Addresses
- Claims Requiring Submission of Clinical Information
- Chiropractic Billing Guide
- Clear Claim Connection and Significant Edits Disclosure Report
- Tools and Resources
- Pharmacy Information
- Resources for Patient Management
- Contact Us
EDI Guides & Samples
Electronic Data Interchange (EDI) Services is your electronic way to submit information. Independence Blue Cross (IBC) provides several resources below, including links of guides and samples, to help you electronically submit claims with more ease and efficiency.
Dual Claims-Processing Environment
IBC is in the process of transitioning to a new claims processing platform, managed and operated by Highmark, Inc. (Highmark), an independent company. We will continue to migrate our membership to the new platform in stages, generally based on when the customer/member’s contract renews. We anticipate that claims processing for all IBC membership will be transitioned to the new platform by mid-2015.
During the migration, we will be working with you in a dual claims-processing and business-operating environment until all of our business is on the new platform. Please keep this in mind as you use the resources available on this page.
For Migrated Member Claims
For Non-Migrated Member Claims: Guides & Samples
- Claims Preprocessing Edits Claims Resolution Document (11/2013)
- Remittance Advice (835) HIPAA Transaction Companion Guide
- Remittance Advice (835) Sample Transaction (File Formats and Data Elements)
- U277 Trading Partner Specification (Claim Status Notification)
- Unsolicited Claim Status (U277) Sample Transaction (File Formats and Data Elements)
Payer ID Grids
Use the following payer ID grids when electronically submitting claims to IBC (includes information for both non-migrated and migrated members).
Note: Clearinghouses may update their submission rules from time to time. Always contact your clearinghouse for confirmation of up-to-date, specific submission requirements.
Updates on Regulations and Processes
- Centers for Medicare & Medicaid Services (CMS)
- Partners in Health UpdateSM
- Provider Bulletins
- Privacy Information (HIPAA)
If you are in need of EDI support for IBC claims, Highmark EDI Operations is your first point of contact. Highmark EDI Operations is available at 1-800-992-0246, Monday through Friday from 8 a.m. to 5 p.m., ET.