- 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
Electronic Data Interchange (EDI)
Simplifying electronic claims submissions
Submitting claims may be one of the most common, time-consuming, and complex administrative tasks that an office staff performs. Using an electronic method – EDI – can result in increased accuracy of claims, better tracking ability, and greater office efficiency and productivity. In addition, you’ll also benefit from error reporting, which allows you to easily correct claims before submission. You will experience fewer payer rejections and administrative complications, resulting in faster claim payments.
Submitting Claims through EDI
When your office submits claims electronically for Independence Blue Cross (IBC), you must use the National Association of Insurance Commissioners (NAIC) code 54704 in the EDI header record to direct your files to IBC.
Product codes are also assigned by NAIC for each of our product lines. A list of professional and facility payer ID codes are available in the following documents:
Note: Clearinghouses may update their submission rules from time to time. Always contact your clearinghouse for confirmation of up-to-date, specific submission requirements.
Transition to New Operating Platform
At IBC, we are working hard to enhance the health and wellness of the people and communities we serve. This means offering the right technology, tools, and processes – which is why we are transitioning our core processing activities to a new operating platform managed by Highmark, Inc. (Highmark), an independent company. This means that IBC claims will be processed using Highmark's system. Moving our processing capabilities to a new platform enables us to offer greater capabilities, increased flexibility in benefit design, and enhanced functionalities to improve the customer experience.Trading Partners
A key step in the migration to the new platform was the transition of EDI transactions from our current gateway to the gateway managed and maintained by Highmark (Highmark Gateway). In November 2013, this process was completed.
If you are a new trading partner who would like to register to submit IBC claims transactions, please visit the IBC EDI Trading Partner Business Center. On this site you can register to submit and receive transactions through the Highmark Gateway, electronically accept a Trading Partner Agreement, and receive your DataStream Trading Partner ID and logon credentials.Resources
IBC and Highmark are committed to ensuring a seamless transition with comprehensive communications and tools during and after the transition to the new platform. For more information, including a Frequently Asked Questions (FAQ) document and complete communication archive, please visit our Business Transformation site.