Get Edi Registration Form - Blue Cross Of Idaho
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How to fill out the EDI Registration Form - Blue Cross Of Idaho online
Filling out the EDI Registration Form for Blue Cross Of Idaho is an essential process for healthcare providers wishing to enroll for electronic data interchange. This guide offers clear and supportive instructions to assist you in completing the form accurately and efficiently.
Follow the steps to complete the EDI Registration Form:
- Click ‘Get Form’ button to obtain the form and open it in the online editor.
- Enter the date on which you are filling out the form in the designated space.
- Fill in the provider information section by indicating your classification. Choose from options like 'Individual Provider' or 'Group/Practice' and include your business name if applicable.
- Complete the provider’s name field (Last, First, MI, and Suffix) along with the Provider NPI Number and Group NPI Number if applicable.
- Provide your business address including the city, state, and zip code.
- Input your telephone number, contact name, and email address.
- Enter your EIN number and check the appropriate box specifying your role in the data submission process, whether you are the direct submitter, working with a billing service, or associated with a clearinghouse.
- Input the ISA06 Submitter ID as requested.
- In the additional information section, select the HIPAA transactions relevant to your practice, such as professional claims or eligibility inquiries.
- Fill in the BCI Provider ID, name of your software or vendor, as well as their contact details including phone, email, and address.
- Once all fields are completed, ensure to sign the form in the designated space for the provider or office manager.
- Review all the information for accuracy, then save your changes, download a copy, print it, or share the form as necessary.
Complete your EDI Registration Form online today to enhance your data processing with Blue Cross Of Idaho.
Blue Cross of Idaho may process a claim filed after 180 days but will deny all claims older than 12 months. We must receive corrected claims or request for payment adjustments within 12 months following the original claim decision.
Fill EDI Registration Form - Blue Cross Of Idaho
This page will help you understand how to submit electronic data interchange (EDI) claims. It will also answer any questions you may have about EDI. Please print and sign the Agreement, and keep a copy on file. When completed, fax to Attn: EDI Help. Blue Cross of Idaho. You'll need to access the provider packet to register or update your information. After receiving a Blue Cross of Idaho remittance advice, go to bcidaho. EDI Registration Form. Section 1: Enter Today's Date. To obtain a user ID and password for the Blue Cross of Idaho website: Logon to providers.bcidaho.
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