Please follow the Enrollment Instructions below to become an electronic submitter for Rhode Island Blue Cross Blue Shield.

Required Documents for those applying for new Submitter IDs

The following documents are required enrollment documents that must be completeed signed, and returned to the Rhode Island BCBS office prior to initiation of electronic claims submission or inquiry.

1. Trading Partner Registration Form

2. Trading Partner Agreement
 

3. EDI Data Transfer Worksheet

If the above links do not work properly, please download these forms from:
www.bcbsri.com

If you have any questions regarding any of the documents in this package, please call the RI BCBS EDI Technology Support Center at 1-401-751-1673 or toll free at 1-855-721-4211.

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.

Trading Partner Registration Form

Section 1

• Enter your Business/Practice or Provider Name as the Trading Partner Section

• Enter the name of the main Contact Person for your office

• Enter your Address, Phone and Fax numbers

• Enter your e-mail address

Section 2

• New applicants may leave the Submitter Number line blank

• For Plans choose "BCBSRI"

• For Transactions, choose the following:

  • 837P- Professional Claims (CMS 1500 Form)

  • 837I- Institutional Claims (UB04 Form)

  • 835- Electronic EOBs

Section 3

• Please skip the "Employer Submitter" section

Section 4

• Sign and Date the bottom of the form

Trading Partner Registration Form

Section 1

• Please fill in today's date and your Business/Practice or Provider name in the first paragraph

Section 4

• Please enter your Business/Practice or Provider Name and mailing address in the Trading Partner section

Signature

• Please complete your Trading Partner information in the Signatures section

EDI Data Transfer Worksheet

(This form will be sent to you by BCBS after they receive the two forms listed above)

Section 1

• Enter your Business/Practice or Provider demographics and contact information

Section 2

• You will be entering OUR information as Vendor Contact

• Please call us for our demographic and contact information

  • You will also need assistance with Sections 3 & 5

• Refer to the table listed above for our contact information

• For the question "After hours contact procedure" enter Email contact preferred

Section 3

• Enter 1 for Maximum number of users/servers initiating FTP

• Enter 3mbps for Internet Connection Speed

• Please call us for our IP Address at 602-439-2525 option 1

  • You will also need our assistance filling out Section 5

Section 4

• Please check off "Client/Vendor will transfer data to BCBSRI" & "Client/Vendor will retrieve data from BCBSRI"

• Approximate size of file in MB should have "N/A"

Section 5

• Check the first box for "Preferred"

• Please call us for assistance with the rest of Section 5 at 602-439-2525 option 1

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:

Director, EDI & Electronic Information Exchange
Blue Cross & Blue Shield of Rhode Island
500 Exchange Street
Providence, RI 02903

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 two weeks from the date of receipt. (Remember that mailing time can take as much as five days).

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 Technology Support Center at 1-401-459-1970.

Testing

Once you have received your Submitter ID and Password from RI BCBS, please call the ClaimShuttle Support Team and set an appointment for a Mailbox setup and Test Transmission to RI BCBS.

Please have 25 test 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.