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Medical Policy, Clinical UM Guidelines, and Pre-Cert Requirements

View requirements for Local Plan and BlueCard Out-of-Area members.

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EDI Vendor Listing

PW_AD048674
 
EDI Services works with clearinghouses and vendors to enable them to submit claims on behalf of their customers directly to Blue Cross Blue Shield of Georgia. 
We currently support the following ANSI formats: 

Transaction Name
 ASC X12 Transaction

Eligibility Inquiry/Response for a Health Plan

270/271 -real-time only

Health Claim Status

276/277 -real-time only

Healthcare Payment/Remittance Advice (ERA)

835

Health Claims and Equivalent Encounter Information

837

Referral Certification and Authorization

278

 
EDI Vendor List 
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Blue Cross and Blue Shield of Georgia, Inc. and Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. are independent licensees of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.