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Electronic Data Interchange EDI FAQs
Electronic Data Interchange (EDI) FAQs
What can I do about an issue with electronic claims and modifiers not transmitting through our clearinghouse? Our EDI department can work with your clearinghouse if there is a problem with us not getting your claims submissions. Contact EDI by email at firstname.lastname@example.org or by phone at 800-868-2505.
Where and how do I submit claims? You should always submit claims electronically to BlueChoice HealthPlan of South Carolina. Be sure to include the member’s complete identification number when you submit the claim. The complete identification number includes the three-character prefix (with the exception of the Federal Employee Program). Do not make up prefixes. Submitting claims with incorrect or missing prefixes and member identification numbers can result in processing delays, as well as claim denials. For prompt payment, we encourage electronic claims submission. Transmit claims in the HIPAA 837 format under the appropriate carrier codes. You should complete all applicable claim information in full to ensure you receive accurate payment without delay. You can also file both professional and institutional claims (primary, secondary and corrected claims) in My Insurance Manager.