We want to make it easy for you to do business with us. This means providing you with online Health Information Technology resources and options that can help you streamline your administrative processes.
Electronic Data Interchange (EDI) Transactions
The fastest way to conduct business with Blue Cross and Blue Shield of Montana (BCBSMT) throughout the entire claims process is via Electronic Data Interchange (EDI) — the computer-to-computer transmission of standardized information. EDI transactions are often identified by numbers assigned by the American National Standards Institute (ANSI). Here are some examples:
- Eligibility & benefits inquiry/response (ANSI 270/271)
- Referrals, pre-certification and authorizations (ANSI 278)
- Electronic claim submission (also known as Electronic Media Claims, or EMC) [ANSI 837P (Professional) or ANSI 837I (Institutional)]
- Claim status request/response (ANSI 276/277)
- Claim payment via Electronic Funds Transfer (EFT)
- Electronic Remittance Advice (ERA), or delivery of claims payment information (also known as ANSI 835)
Online Transaction Schedule
Effective Jan. 1, 2013, online Eligibility & Benefits (270/271) and Claims Status (276/277) transactions may be conducted almost continuously, with the exception of Sunday, 7 p.m. to 11 p.m., MT.*
*Non-routine downtime will be communicated via designated third party independent vendor websites at least one week in advance.
- Participation in all electronic options available to BCBSMT providers is strongly encouraged. See the E-Commerce Connections menu below for more details.
- Follow standards and guidelines. When conducting EDI transactions, health care providers, billing agents and clearinghouses must follow Health Insurance Portability and Accountability Act (HIPAA) standards.
How can you streamline your administrative processes? The answer is simple: Electronic Data Interchange (EDI) transactions. See below for electronic options available to BCBSMT providers.
- AvailityTM – To register with Availity or learn more about services available to BCBSMT providers, visit the Availity website at availity.com, or call Availity Client Services at 800-AVAILITY (282-4548).
- BCBSMT Secure Online Services – Register or log in with user ID and password.
- AvailityTM – To register with Availity or learn more about services available to BCBSMT providers, visit the Availity website, or call Availity Client Services at 800-AVAILITY (282-4548). Have additional E-Commerce questions? Contact our Electronic Commerce Center by emailing firstname.lastname@example.org.
- If you have other questions related to BCBSMT's Secure Online Services, contact Provider Relations at 800-447-7828, Ext. 6100.
- Holiday Schedule Reminders
Verification of eligibility and/or or benefit information is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage applicable on the date services were rendered.