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ANSI ASC X12N 5010 Specifications
These documents are in portable document format (PDF) and may be downloaded from this website.
FEP 837 Health Care Dental Claim Companion Document
This statement advises providers of the efforts of Arkansas Blue Cross and Blue Shield to address the administrative simplification provisions of HIPAA.
Connectivity/Communications (Moveit DMZ)
Moveit DMZ Transition Form
Moveit DMZ User Manual
Contact EDI Services
This section contains contact information.
Electronic Claims Testing
This information will help lead you through the process you must follow to become approved for electronic claims submission in the new HIPAA-compliant format.
EDI Report User Guide
Electronic Data Interchange
Private Business Transaction Companion Document
This document provides additional guidance concerning the segments/data elements necessary to successfully process HIPAA-compliant ANSI X12N version 5010 270/271, 276/277 and 278 transactions for private business members.
This link will take you to the WPC electronic data interchange health care transactions site. This site will contain the ANSI X12 implementation guidelines that can be downloaded.
All forms must be signed and returned to EDI Services via mail or fax. These forms are in portable document format (PDF) and allow you to complete them online, print, sign and mail or fax to the appropriate address/fax number.
APII Enrollment Form
This form is to be used by providers who are participating in the APII project and currently do not have AHIN access.
Electronic Remittance Advice (ERA)
Submitter Information Update Form
Trading Partner Agreement (TPA)
Trading Partner Agreement Definitions
HIPAA Compliant Vendors List
A directory of electronic-billing vendors who have successfully tested with us and are in production for the Health Insurance Portability Accountability Act (HIPAA) version of the X12N 837 Health Care Claim.
Secondary Coverage Information
Health Advantage Billing Requirements for ANSI 837I Secondary Coverage
Health Advantage Billing Requirements for ANSI 837P Secondary Coverage
Institutional COB Billing Requirements
ITS Institutional Secondary Payer Requirements.
ITS Professional Secondary Payer Requirements
Professional COB Billing Requirements
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Shield Association and is licensed to offer health plans in all 75 counties of Arkansas.
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