Companion Guides and Business Rules
BCBSLA Companion Guides
5010 Eligibility Inquiry and Response Companion Guide
This guide was developed by our EDI department to help you with HIPAA transactions for benefit inquiries and responses.
EDI's Guide to HIPAA 5010 Testing & Implementation
This guide was developed by our EDI department to help you with testing and implementation of HIPAA 5010 for electronic transactions with BCBSLA.
5010 Claim Status Request and Response Companion Guide
This guide was developed by BCBSLA to be used in conjunction with 5010 ASC X12N 276/277 Claim Status Request and Response (005010X212) TR3.
5010 Services Review-Request for Review and Response Companion Guide
This guide was developed by BCBSLA to be used in conjunction with 5010 ASC X12N 278-13/278-11 Services Review-Request for Review and Response (005010X217) TR3.
5010 Remittance Advice Companion Guide
This guide was developed by BCBSLA to be used in conjunction with 5010 835 Healthcare Claim Payments/Remittance Advices (005010X221A1).
5010 Professional Claims Companion Guide
This guide was developed by BCBSLA to be used in conjunction with 5010 837P Professional Claims (005010X222A1).
5010 Institutional Claims Companion Guide
This guide was developed by BCBSLA to be used in conjunction with 5010 837I Institutional Claims (005010X223A2).
5010 Dental Claims Companion Guide
This guide was developed by BCBSLA to be used in conjunction with 5010 837D Dental Claims (005010X224A2).
5010 Clearinghouse Services Guide
This guide provides a comprehensive overview of our Clearinghouse services and provides Electronic Data interchange (EDI) information on enrolling in EDI services, hours of operation, processing cycles, communication requirements, file formats and reports.
BCBSLA Business Rules
Institutional UB04 Claim Business Rules
This document was designed for technical and office staff to develop validation edits and to assist in the submission and/or correction of BCBSLA Institutional claims.
Professional 837P/1500 Business Rules Guide
This document was designed to provide technical staff with the criteria needed to develop validation edits for BCBSLA Professional claims.
