New York Blue Cross Blue Shield: ASK
Please follow the Enrollment Instructions below to become an electronic submitter to New York Blue Cross Blue Shield ASK.
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. ERA Enrollment (Electronic Remittance)
If you are an existing Submitter, but need to change your information please complete the following:
1. Change Form
https://www.ask-edi.com/forms/change-of-information.shtml
We can now process 276/277 requests (claim status). If this is a transaction you would like to utilize please make sure to enroll with the payer.
EDI Enrollment Form
Section 1: Trading Partner Information
Enter your Business/Practice or Provider Name
Enter your address, phone and fax numbers
Enter the name of the main contact person for your office
Enter your e-mail address
Section 2: Type of Organization
Please select the appropriate Organization type of your business, indicate whether you are a clearinghouse or billing service. Leave blank if description does not apply.
Section 3: Vendor Information
For Software Vendor enter the information for the software or vendor that creates your 837 files you need ClaimShuttle to transfer for you. If you have paid for our SolAce billing software please call our support line for our SolAce software information.
Section 4: Communication Type
Please choose "Internet"
Section 5: Billing NPI's and Provider Names
Please place a check mark on the box for "Professional" or "Institutional" claims.
Complete the table with your Billing NPI's and Organization/Provider Names
Section 5B: Select Payer
Choose the carrier you will be sending claims to
Section 6: Signature
Sign and Date the form
ERA Enrollment Form
If you would like to receive your EOB's electronically in ClaimShuttle, please complete this form. Please complete after you have received your Trading Partner ID
Enter your Provider Name
Complete your Business Demographic Information
Enter your TIN or EIN and your NPI
Enter your Trading Partner ID (also called Submitter ID)
Complete your Contact Information
Enter your TIN and NPI (must match what's listed above)
For Software Vendor enter the information for the software or vendor that creates your 837 files you need ClaimShuttle to transfer for you. If you have paid for our SolAce billing software please call our support line for our SolAce software information.
Select your reason for submission (either New or Change Enrollment)
Complete the signature section and Submit
Change Form
Complete this form if you need to change your Demographic information, enroll additional NPI Numbers, or change software vendor information
Complete Section 1 with your information
Select what you are changing in Section 2 and if they ask for further information on the next screen please enter it accordingly
Submitting your Forms
It is recommended that you keep a copy of all the forms you will be submitting for your records. Mail the enrollment forms reflecting original signatures to:
ASK, Inc.
PO Box 3500
Topeka KS 66601-3500
Or Fax: 785-290-0720
Or Email askedi@ask-edi.com
It is very important that you complete and return the entire enrollment packet as described above. Incomplete packets will not be processed and will be returned to the submitter.
Waiting for a Response
Once the complete provider enrollment packet has been received, the documents will be processed. Processing will take approximately five to seven business days from the date of receipt. (Remember that mailing time can take much longer, therefore fax or email is preferred.)
After processing, a confirmation will be faxed to you as notification to begin filing claims electronically. If neither confirmation nor a returned packet is received after two weeks, contact the ASK EDI Technology Support Center at 1-800-472-6481.
Testing
Once you have received your Submitter ID and Password from ASK, please call to ClaimShuttle Support Team and set an appointment for a Mailbox setup and Test Transmission to ASK.
Please have 25 claims ready for testing. Test files should consist of a variety of claims that represent the type of claims you will be submitting once production status is achieved. Test claims will not be processed for payment, but will be validated against production files; therefore, they must contain valid patient procedure, diagnosis, and provider information.