Anthem Blue Cross Blue Shield of Nevada by vsb11259

VIEWS: 0 PAGES: 1

									Emdeon EDI Transaction Center                                                                                                        Page 1 of 1




   Anthem Blue Cross Blue Shield
   of Nevada




   Line(s) of Business
   Medical, Hospital, Dental, and Encounter Claims
   FAST FACTS Last updated: 02/25/09
   The following requirements are specific to Emdeon. Check with your vendor before making system changes.
    Payer ID             SB765 Professional
                         12B20 Institutional
                         84101 Dental

    Products             All lines of business for Anthem Blue Cross Blue Shield of NV, Bluecard (out-of-state BCBS) and FEP
                         (Federal Employee Program)

    Member ID            Required.
    Number                      Anthem BCBS of NV: 9-11 numeric or 2-3 alphas followed by 7-9 numbers
                                BlueCard and NASCO: 3 alpha characters followed by 1-14 alpha-numeric characters
                                HMO/BlueAdvantage: 9-11 alpha numeric characters or 3 alphas followed by 9-11 numbers
                                FEP: R followed by 8 numbers

    Group Number         Optional

    NPI / Provider       Required. Format for Nevada providers:
    Number                      Professional Claims: NPI 10 numeric digits; For Exempt Providers only: 2 alpha followed by 4
                                numeric (BCBS NV Legacy ID), ie., CC1234
                                Institutional Claims: NPI 10 numeric digits; For Exempt Providers only: 2 alpha followed by 4
                                numeric (BCBS NV Legacy ID), ie., CC1234

    Federal Tax ID       Required. A 9 digit number. Federal Tax ID Number (TIN) or Social Security Number (SSN) of the facility
                         or provider.

    Authorization        Authorizations required for some services. Authorization number on claim when submitted electronically is
    Number               optional yet recommended for faster claims adjudication.

    Attachments          To confirm whether a procedure requires an attachment, log onto www.edianthem.com. If the procedure
                         requires paperwork (PWK), submit the claim electronically and follow the instructions for submitting the
                         supporting documentation.

    eCOB                 Secondary/COB claims can be submitted electronically to Anthem BCBS of NV

    Exclusions           None. All claims can be submitted electronically.

    Encounters           Encounters must be submitted with billed charges and will be adjudicated as encounters.

    Customer             For questions or concerns regarding claim routing, clearinghouse rejections or transactions responses
    Service, Emdeon      contact:
                                 Your vendor. If you use software maintained by a company other than Emdeon to submit your
                                 claims electronically, call your vendor. Your vendor should contact Emdeon if further assistance
                                 needed.
                                 ON 24/7. If you use an Emdeon product, you may have access to Emdeon's online support tool,
                                 ON 24/7, enabling you to obtain customer support online 24 hours a day, 7 days a week.
                                 Emdeon Batch Help Desk: 1.800.845.6592. If you use an Emdeon product to submit your claims,
                                 contact us directly at this phone number.
                         Emdeon Customer and Sales Support: http://www.emdeon.com/support/support.php
                         Electronic Claims Resource Center: http://transact.emdeon.com

    Customer             Anthem BCBS:
    Service, Payer             EDI Helpdesk: 1.800.332.7575 ...or...
                               Email: edianthemwest.support@anthem.com

    Real-Time
                         Eligibility (270/271)
    Transactions

    Timely Filing        Payer may consider the following Emdeon electronic reports as proof of timely filing:
    Limits                      RPT-04
                                RPT-10 or -11

    ERA/EFT              Electronic Remittance Advice (835) is available and utilization encouraged. To implement, contact your
                         vendor. Contact payer directly regarding availability of Electronic Funds Transfer. Log onto
                         http://transact.emdeon.com for list of payers offering ERA/EFT through Emdeon.




http://testsite.transact.emdeon.com/factsheets/edi_fact_sheet_SB765.php                                                               4/24/2009

								
To top