Mississippi Blue Cross Blue Shield

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


Required Documents for those applying for new Submitter IDs

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

1. BCBSMS Electronic Submissions of Claims Agreement

If the link above does not work properly, please download the form from here:

You will find the form under the Administrative section at the very bottom of the page

If you have any questions regarding any of the documents in this package, please phone the Blue Cross Blue Shield EDI Technology Support Center at 1-800-826-4068.


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.


Blue Cross & Blue Shield Agreement

  • Enter today’s date in the first paragraph and your Business/Practice or Provider name.

  • Complete page 5 of the document.

    • Complete the Provider information section on the left side

      • If you are using a billing agency please fill in the billing agency information on the right.

  • Complete the Electronic Claims Information Worksheet

    • Enter your business/practice or provider name

    • Enter your address and contact numbers

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

    • Enter the BCBS ID’s and NPI’s of the providers for whom you will be billing.

  • If you would like to receive your EOBs electronically, please write the following statement at the bottom of the Electronic Claims Information Worksheet:

    • “Please enroll the provider numbers above to receive Electronic Remittance Advices”


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:


Blue Cross blue Shield of Mississippi
ATTN: EDI Services
PO Box 1043
Jackson, MS 39215-1043

Fax - 601.936.5886

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 Technology Support Center toll-free at 1-800-826-4068.



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

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