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

Required Documents for those applying for New Submitter ID's

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

1. Electronic Provider Profile Form
2. Secure File Gateway Transition
3. BlueCross BlueShield of TN Electronic Vendor Profile (For Billing Agents/Clearinghouses ONLY)

If the links listed above do not work properly, please download the forms from:
https://provider.bcbst.com/tools-resources/digital-resources/

• For Electronic Provider Profile Form or BlueCross BlueShield of TN Electronic Vendor Profile Form click on the more under "Getting Started".

• For the Secure File Gateway Transition Form click on the more under "Technical Information"

If you have any questions regarding any of the documents in this package, please call the Medicaid EDI Technology Support Center at 423-535-5717.

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.

Electronic Billing Request (Electronic Provider Profile Form)

Section 1

• Enter your Business/Practice or Provider Name (if applicable)

• Enter your Business/Group NPI number (if applicable)

• Enter your Provider Name and NPI number

• Enter your Tax ID number

• Enter the information for the contact person in your office

Section 2

• Choose "Filing Directly with Purchased Software"

  • 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.

  • For Submitter ID: please call us for this number if you use SolAce, if not call the software vendor you use to create your files

  • Check off Reports and Remits (new applicants may leave the Mailbox Name blank)

• Choose "Provider Office" on the question regarding who will receive your Remits

Section 3

• Please select SFTP for User Access

• For account type "Batch ID" Please list the name of the person who will be using ClaimShuttle to bill your claims and their contact information. Repeat the user entry in the "Individual ID" and enter additional individual users if necessary.

Signature Section

• Complete the signature section with your information

Secure File Gateway (SFG) Request for Access

Section 1

• Enter your Business/Practice or Provider Name

• Enter your Business/Group NPI number

• Vendor Name: 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 Tax ID number

• Enter the information for the contact person in your office

• Your User ID's and Passwords will be faxed to the fax number listed; if the fax number is left blank, the confirmation will be sent to the mailing address on file.

Section 2

• New applicants should leave this section blank, otherwise list existing mailbox names for Reports and Remits

Section 3

• For Batch ID, enter the name and contact information of the person that will be using ClaimShuttle to bill your claims.Repeat the user entry in the "Individual ID" and enter additional individual users if necessary.

Section 4

• Complete the signature section with your information

Electronic Vendor Profile (For Billing Services ONLY)

Section 1

• Select "Billing Agency"

• Enter your Business/Practice or Provider Name

• Enter your Tax ID

Section 2

• Complete your demographic information

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

Section 3

• Part A, For the 837 version to be submitted enter 5010A1

• On the table, select 837P for Professional claims or 837I for Institutional claims

• Part B, Select "Yes" since you are the billing service that will be using ClaimShuttle to submit claims for your client

  • Enter your business information on the table

  • Select if you would like separate file names and mailboxes for the clients you will be billing for

Section 4

• Select "Purchased Software"

  • Complete the software vendor section with 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.

Section 6

• Enter the name of the person that will be using ClaimShuttle to bill your claims to BCBS of TN

Section 7

• Please complete this section with your information

Section 8

• For the Modem Access Form Section please call us if you use SolAce. If you do not please contact your software vendor that creates your 837 files you need ClaimShuttle to transmit for you.

• Complete the bottom section with your information

Note: If this form has been updated by BCBS of TN and now gives an option for SFTP in lieu of the modem system, please select SFTP.

Submitting your Forms

It is recommended you keep a copy of all the forms you will be submitting for your records. Mail or fax the enrollment forms reflecting original signatures to the address/fax listed on the bottom of the forms.

It is very important that you complete and return the entire enrollment packet as described above. Incomplete documents 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 at 423-535-5717.

Testing

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

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.