Blue Cross of California (Anthem Central)

Please follow the Enrollment Instructions below to become an electronic submitter for Anthem Blue Cross of California.

 

Required Documents

The following are required enrollment documents that must be completed, signed and returned to the Anthem office prior to initiation of electronic claims submission or inquiry.


1. Trading Partner Agreement
2. EDI Claims Enrollment Form
3. ERA/EFT Enrollment Form

If the links above do not work properly, please download the forms from here:
http://www.anthem.com/wps/portal/ca/culdesac?content_path=provider/f2/s0/t0/pw_a111401.htm&rootLevel=1&name=edi&label=Register

If you have any questions regarding any of the documents in this package, please phone the Anthem EDI Technology Support Center at (800) 470-9630

 

We can now process 276/277 requests (claim status). If this is a transaction you would like to utilize please make sure to enroll with the payer.

 

EDI Registration Form

Heading

  • Please select "New Submitter"

  • Choose "Physician/Provider" if you will be using ClaimShuttle to submit claims directly to BCBS

  • Choose "Billing Service" if you are a Billing Service.

Section 1

  • Please enter your Business/Practice or Provider Name as the Trading Partner

  • Enter your address, phone and fax numbers and email address

  • Enter the name of the main contact person for your office

  • Enter your NPI and Tax ID

Section 2

  • Please mark "Software/System Vendor" and enter the information for the software or vendor that creates your 837 files you need ClaimShuttle to transfter for you.

  • If you have paid for our SolAce billing software please call our support line for our SolAce software information.

Section 3

  • For Data Transmission Method please select Secure FTP

Section 4

  • If you are a new applicant select "Assign New" and enter your information under the Submitter Name and Demographics section. (Leave the Clearinghouse line blank)

Section 5

  • Please mark the following:

    • 837P - Professional Claims for CMS 1500 billings

    • 837I - Institutional Claims for UB04 billings

    • 835 - Payment Advice/Remit to receive your EOB's electronically in ClaimShuttle

 

Anthem ERA/EFT Enrollment Form

Please hold onto this form until you receive your Submitter ID from Anthem

Heading: Select either Institutional or Professional Section 1

  • Complete this section with your information

Section 2

  • If you use ClaimShuttle in your office and have received your own Submitter ID from Anthem, choose the first box for "We are direct claim submitter..." and enter your Submitter/Mailbox ID. For your ERA Translation software, enter ClaimShuttle by Axiom Systems Inc. If you have another software you use to translate you ERA's enter that information. If you have purchased SolAce please call for our vendor information.

  • If you use a Billing Service, choose "Our vendor will retrieve all ERA..." And enter your Billing Service's name and information. (NOTE: AXIOM Systems Inc. is NOT a Billing Service)

Section 3

  • Complete the Signature section

Attachment B is for the EFT portion if you would like your payments to be directly deposited into your accounts.

 

Submitting your Forms

It is recommended that you keep a copy of all the forms you will be submitting for your records. Please Fax or Email the completed forms to:

 

1-877-330-2585 Or EDIenroll-ca@wellpoint.com
 

It is very important that you complete and return the entire enrollment packet as described above. Incomplete packets will not be processed and will be returned to the submitter.

 

Waiting for a Response

Once the complete provider enrollment packet has been received, the documents will be processed. Processing will take approximately 10-12 weeks from the date of receipt.

After processing, a confirmation will be emailed to you as notification to begin filing claims electronically. If neither confirmation nor a returned packet is received after two weeks, contact the Anthem EDI Technology Support Center at 1-800-470-9630.

 

Testing

Once you have received your Submitter ID and Password from Anthem, please call the ClaimShuttle Support Team and set an appointment for a Mailbox setup and Test Transmission.

Please have one valid test claim ready for testing. The test file should represent the type of claims you will be submitting once production status is achieved. The test claim will not be processed for payment but will be validated against production files; therefore, it must contain valid patient procedure, diagnosis, and provider information.