Electronic Data Interchange (EDI)
Healthy Blue uses Availity as its exclusive partner for managing all electronic data interchange (EDI) transactions. EDI, including electronic remittance advices (ERAs) and electronic funds transfers (EFTs), allows for a faster, more efficient and cost-effective way for providers and employers to do business.
EDI lets you:
- Process claims faster by submitting coordination of benefits electronically and fixing errors early with in-system notification and correction.
- Reduce overhead and administrative costs by eliminating paper claim submissions.
- Speed up enrollment and payment for employer groups benefits.
- Upload files through secure file transfer protocol (SFTP) or directly in Availity or through the Availity Portal.
Using Availity, you can complete the following HIPAA transactions:
- Healthcare Claim: Dental (837D)
- Healthcare Claim: Institutional (837I)
- Healthcare Claim: Professional (837P)
- Healthcare Claim Payment/Advice (835)
- Healthcare Claim Status Request and Response (276/277)
- Healthcare Eligibility Benefit Inquiry and Response (270/271)
- Healthcare Services Prior Authorizations (278)
- Healthcare Services Inpatient Admission and Discharge Notification (278N)
- Medical Attachments (275)
The Availity EDI submission options:
- Use existing clearinghouse or billing vendor:
- Work with your vendor to ensure connection to the Availity EDI Gateway
- Become a direct submitter with the Availity EDI Clearinghouse:
- A third-party practice or revenue cycle management system capable of generating EDI batch files is required.
Already have an Availity login but want to submit EDI transactions?
- Log in to Availity.
- Select My Providers > choose Enrollments Center > select Transaction Enrollment.
- Follow the steps to enroll as a trading partner.
New to Availity and want to submit EDI transactions?
- Choose an administrator to register your organization.
- When the admin is ready to register, choose the register button on the top of the page.
- Select your organization type and complete the registration process.
- Admin should check email to verify account.
- Once account is verified, admin will agree to the disclaimer, set up security questions, and change password and set up authorized users.
Don’t have an Availity account?
Payer IDs route EDI transactions to the appropriate payer.
Your Payer Name is Healthy Blue.
The Payer IDs are:
- Dual Advantage − 00551
- Medicaid − 00661
Availity Payer IDs:
Electronic remittance advice (ERA)
Use Availity to register and manage ERA account changes with these three easy steps:
- Log in to Availity.
- Select My Providers.
- Select Enrollment Center and choose Transaction Enrollment.
Electronic funds transfer (EFT)
Use the EnrollHub™, a CAQH Solutions™ enrollment tool, to register and manage EFT account changes.
EnrollHub makes it easy for you to handle multiple payers at once, reducing administrative time and costs.
Please contact Availity Client Services with any questions at 1-800-AVAILITY (282-4548).
Useful EDI Information:
Availity EDI Connection Service Startup Guide – Information to get you started with submitting Electronic Data Interchange (EDI) transactions to Availity, from registration to ongoing support.
Availity EDI Companion Guide – A supplement to the HIPAA TR3s. It describes the Availity Health Information Network environment, interchange requirements, transaction responses, acknowledgements, and reporting for each of the supported transactions as related to Availity.