Electronic data interchange (EDI)

Anthem Blue Cross and Blue Shield (Anthem) uses Availity* as its exclusive partner for managing all electronic data interchange (EDI) transactions. EDI, including electronic remittance advices (ERAs) and electronic funds transfers (EFTs), allows for a faster, more efficient and cost-effective way for providers and employers to do business.

• Process claims faster by submitting coordination of benefits electronically and fixing errors early with in-system notification and correction
• Reduce overhead and administrative costs by eliminating paper claim submissions
• Speed up enrollment and payment for employer groups benefits
• Upload files through file transfer protocol (FTP) or directly in Availity as a batch or single claim submission

For Anthem in Availity, you can complete the following HIPAA transactions:

• Healthcare claim: professional (837P)
• Healthcare claim: institutional (837I)
• Healthcare claim: dental (837D)
• Healthcare eligibility benefit inquiry and response (270/271)
• Healthcare services review and response (278)
• Healthcare services inquiry and response (278)
• Healthcare claim payment/advice (835)
• Healthcare claim status request and response (276/277)
• Medical attachments (275)

Ways you can use EDI with Availity

Availity’s EDI clearinghouse options

1. EDI clearinghouse for direct submitters:
   • For organizations with fewer than 10,000 monthly transactions
   • Submit batch files through the portal or Secure File Transfer Protocol (SFTP) using third-party software such as billing software
2. EDI clearinghouse for high-volume trading partners
3. Or, use your existing clearinghouse vendor:
   • Work with your vendor to ensure connection with the Availity EDI Gateway

Already have an Availity login but want to submit EDI transactions?

1. Log into Availity.
2. Choose My Providers then select Enrollments Center then select Transaction Enrollment.
3. Follow the steps to enroll as a trading partner.

New to Availity and want to submit EDI transactions?

1. Visit www.availity.com and select Register.
2. Select your organization type and complete the registration process.
3. Check your email to verify your account.
4. Once your account is verified, agree to the disclaimer, set up your security questions and change your password.
5. Set up any authorized users.

Payer ID

Payer IDs route EDI transactions to the appropriate payer.

Anthem payer name and ID:

• Your Payer Name is Anthem BlueCross and Blue Shield (Anthem)
• Your Payer ID is 27514
• Note: If you use a billing company or clearinghouse for your EDI transmissions, please work with them on which payer ID they want you to use
  

Electronic remittance advice (ERA)

Use Availity to register and manage ERA account changes with these three easy steps:

1. Log in to Availity .
2. Select My Providers.
3. Select Enrollment Center and choose ERA Enrollment.

Note: If you were previously registered to receive ERA, you must register using Availity to manage account changes. No other action is needed. If you use a clearinghouse, billing service or vendor, please work with them on ERA registration.

Electronic funds transfer (EFT)

Use the EnrollHub™, a CAQH Solutions™ enrollment tool to register and manage EFT account changes.

EnrollHub™ makes it easy for you to handle multiple payers at once, reducing administrative time and costs.

If you were previously registered to receive EFT only, you must register using EnrollHub to manage account changes. No other action is needed.

Become a trading partner

Providers, billing services and clearinghouses can register to exchange 270/271 (eligibility), 276/277 (claim status), and 835 (electronic remittance advice) X12 transactions for Anthem BlueCross and Blue Shield members and claim payments. To become a trading partner, submit a Trading Partner Agreement Form and an Electronic Data Interchange (EDI) Registration Form. An E-Solutions representative will provide outreach to complete the trading partner ID assignment and establish connectivity with our Enterprise Clearinghouse.

The Trading Partner Agreement Form is coming soon

Contact Availity

Please contact Availity Client Services with any questions at 1-800-AVAILITY (800-282-4548) Monday to Friday, 8:00 a.m. to 7:30 p.m. (Eastern time).

Availity, LLC is an independent company providing administrative support services on behalf of Anthem BlueCross and Blue Shield.

Related resources

For EDI transaction companion documents, please visit our Provider Training Academy page.

Provider tools & resources

• Log in to Availity
• Launch Provider Learning Hub
• Learn about Availity
• Prior Authorization Lookup Tool
• Prior Authorization Requirements
• Claims Overview
• Reimbursement Policies
• Provider Manuals, Policies & Guidelines
• Referrals
• Provider Training Academy
• Forms
• Pharmacy Information
• Provider News & Announcements

Interested in becoming a provider in the Anthem network?

We look forward to working with you to provide quality services to our members.

© 2023 copyright of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is the trade name of HealthPlus, LLC, an independent licensee of the Blue Cross and Blue Shield Association.

* Availity, LLC is an independing company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield.

* CarelonRx, Inc. is and independent company providing pharmacy benefit management services on behalf of the health plan.

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