Connecticut Blue Cross Blue Shield (Anthem Central)

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

 

Required Documents

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

Electronic Data Interchange (EDI) Services

  • Print out the following forms:

  1. Submitter-EDI Registration Form

  2. ERA 835 Registration Form (to apply for electronic EOB’s)

 

If the links listed above do not work properly follow the link below then select: EDI Registration Forms

www.anthem.com/wps/portal

 

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

Section 1

  • Please select “New Electronic Submitter”

  • Enter your Business/Practice or Provider Tax ID

  • For Software Vendor enter the information for the software or vendor that creates your 837 files you need ClaimShuttle to transfer for you. If you have paid for our SolAce billing software please call our support line for our SolAce software information.

  • Enter your Billing NPI Number

Section 2

  • Select the State you are billing for

Section 3

  • Select the Type of Claim you will be submitting

Section 4

  • Select “Provider” if you will be using ClaimShuttle to submit your claims directly to Anthem

  • Select “Billing Service” if you are a Billing Service submitting claims for Providers.

Section 5

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

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

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

Section 6

  • For Delimiters, please enter the following:

    • Element Separator: *

    • Component Separator: :

    • Segment Terminator: ~

Section 7

  • Please mark the following:

    • 837 P – Professional Claims for CMS 1500 billings

    • 837 I – Institutional Claims for UB04 billings

Section 8

  • For Data Transmission please select “SFTP”

    • If the SFTP option is not listed, please write it in underneath the last option listed and select it.

Section 9

  • For Report Compression please select “Zipped”

Section 10

  • Please sign and Date this section.

 

835 Electronic Remittance Advice

After you have received your Anthem Submitter ID, please fill this form out if you would like to receive your EOBs electronically in SolAce

Payer

  • Select the Payer (Anthem)

Provider Information

  • Please enter your Business/ Practice or Provider Name

Provider Address

  • Enter your address, city, state, and zip

Provider Data

  • Enter your Tax ID

  • Enter your NPI

  • Enter your Trading Parnter ID (also called Submitter ID)

Provider Contact Information

  • Enter the main contact for your office

  • Make sure to fill out all fields in this section

Preferences

  • Choose either Tax ID or NPI

  • In the drop down, select "Direct Download Secure FTP"

Clearinghouse Information

  • Leave this section blank

Reason for Submission

  • If this is a new registration select New

Authorized Signature

  • Enter the name and title of the authorized individual submitting registration

Check the box then press Submit

 

 

Submitting your Forms

It is recommended that you keep a copy of all the forms you will be submitting for your records. Mail the enrollment forms reflecting original signatures to:

 

Anthem Blue Cross and Blue Shield
EDI Business 4W020
2 Gannett Drive
South Portland, ME 04106

Or for faster processing:
Fax to: 207-822-7333
 

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 two weeks from the date of receipt. (Remember that mailing time can take as much as five days.)

After processing, a confirmation will be faxed 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 (800) 334-8262.

 

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 25 test claims ready for testing. Test files should consist of a variety of claims that represent the type of claims you will be submitting once production status is achieved. Test claims will not be processed for payment but will be validated against production files; therefore, they must contain valid patient procedure, diagnosis, and provider information.