EDI Companion Guides
Our Electronic Data Interchange (EDI) Companion Guides describe specific requirements for trading partners who exchange electronic transactions directly with Blue Shield of California Promise Health Plan (not through a vendor or clearinghouse). Our companion guides contain supplementary instructions to the ASC X12 national implementation guides, and do not replace or modify the implementation guides.
Follow the instructions found in these companion guides to ensure effective and efficient transaction processing.
Companion guides (Effective January 1, 2019)
834 Outbound Enrollment Companion Guide (PDF, 366 KB)
837 EDI Companion Guide (PDF, 5.1 MB)
Secondary 277CA - Adjudicated Encounter Companion Guide (PDF, 569 KB)
Secondary 277CA - Adjudicated Encounter FAQs (PDF, 122 KB)
834 5010 Old VS New CG Comparison (Excel, 28 KB)
Flat File Companion Guide (Excel, 621 KB)
4010 Mapping Companion Guide (Excel, 209 KB)
274+ Companion Guide (PDF, 1.2 MB)
274+ Field Change Guide (Excel, 24 KB)
274+ Provider FAQ (PDF, 209 KB)
Large Group Validation Instructions/FAQs (PDF, 43 KB)
Local code encounter crosswalk
Find the national codes that must replace local billing codes. For billing claims, Blue Shield Promise continues to utilize Medi-Cal local codes following the Medi-Cal Fee-for-Service Program's phased approach to convert the interim (local) codes to national values.
National Drug Code requirements for reporting physician administered drugs
Learn about Blue Shield Promise code submission requirements for submitting claims and encounters when reporting physician administered drugs for Medi-Cal and Cal MediConnect members.