Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI). In order to be able to submit claims electronically to AK Blue Cross Blue Shield, you must first go to onehealthport.com and Register for an OHP User ID (if you do not have one). You may click on this link to launch the One Health Port Registration Page: http://www.onehealthport.com/register/index.php Once you receive your OHP User ID, you will then be able to access the forms below from your OHP account.

Required Documents for those applying for new Submitter ID's

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

Wyoming Blue Cross Blue Shield claims will now be handled by the Availity Clearinghouse. 

Please click here to review our Availity enrollment instructions.

Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI).

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 MA BCBS office prior to initiation of electronic claims submission or inquiry. 1. EDI Trading Partner Enrollment Form 2. Secure FTP Account Request Form In order to receive these forms you will need to call MA BCBS directly and let them know you need the forms listed above because you are applying for a Submitter ID in order to become a Direct Submitter using SolAce EMC.

Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI).

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 LA BCBS office prior to initiation of electronic claims submission or inquiry. 1. Electronic Trading Partner Agreement (you will need to complete 2 copies of this form in ink) If the above link does not work properly, please go here to download the form: http://www.bcbsla.com

Enrollment Instructions

Required Documents for those applying for new Submitter ID's

The following documents are required enrollment documents that must be completed, signed and returned to the ASK office prior to initiation of electronic claims submission or inquiry. 1. Enrollment Form (Claims) 2. Enrollment (Electronic Remittance) If you are an existing Submitter, but need to change your information please complete the following: 1. Change Form http://www.ask-edi.com/pdf-docs/EDI_Change_Form.pdf

Required Information

Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI).

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 Idaho Blue Cross office prior to initiation of electronic claims submission or inquiry. 1. EDI Registration Form If the link listed above does not work properly, please go here: https://www.bcidaho.com/edi_clearinghouse/index.asp Then scroll down to Provider Information and click on “”EDI Registration Form”

Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI).

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 BCBS office prior to initiation of electronic claims submission or inquiry. 1. Registration Instructions and Form If the link above does not work properly, please download this form from: http://www.wellmark.com/Provider/ClaimsAndPayments/SubmittingClaims.aspx

Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI).

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 Pinnacle office prior to initiation of electronic claims submission or inquiry. If the above links do not work properly, please download them from:

Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI).

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 HMSA office prior to initiation of electronic claims submission or inquiry. 1. Electronic Trading Partner Agreement If the above link does not work properly, please download the form from: www.hmsa.com/portal

Enrollment Instructions

Thank you for your interest in Electronic Data Interchange (EDI).

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: http://www.bcbsms.com You will find the form under the Administrative section at the very bottom of the page

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