Managing Electronic Claims and Encounters
Blue Shield of California Promise Health Plan requires that you submit all encounters electronically. We encourage you to submit all your claims and receive your payments electronically as well, for faster processing and payment, using electronic data interchange (EDI).
EDI allows paperless encounter submissions, as well as billing and payment for healthcare services and supplies, automating many types of routine inquiries.
EDI benefits
- Reduced administrative costs. The average physician's office can save up to $46,000 annually using electronic transactions for common administrative tasks, according to a report by The Milliman Group (PDF, 96KB)
- Improved accuracy of billing and posting information
- Reduced office paperwork
- Improved cash flow
- Faster claims processing
- Improved security for protected information
Using EDI, you can automatically post electronic remittance advice (ERA) to your practice management system, reducing data entry, speeding up patient billing, and freeing up staff for more important tasks.
To receive electronic remittance advices (ERAs) for Blue Shield Promise claims, register with an approved clearinghouse. Download the approved list of clearinghouses (PDF, 89 KB).
To send Blue Shield Promise claims electronically, use only the approved clearinghouse listed below:
OfficeAlly
Payer ID: C1SCA
(866) 575-4120
Get paid electronically
Electronic funds transfer (EFT) allows you to have your claims payments deposited directly into your business account, minimizing your risk of lost checks or lockbox delays.
EDI companion guides
Access our companion guides for trading partners who exchange electronic transactions directly with us.
Sign up for electronic remittance advice and electronic payments
Find the information and forms you need to enroll in ERA and EFT.
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.
Provider dispute resolution policy and procedures
Communicate your questions and concerns to Blue Shield Promise and learn how to appeal or dispute a claim payment.