FAQs
Electronic Services

Q.		What is EDI?
A.		Electronic Data Interchange (EDI) is the electronic exchange of business information in a common standardized format.
Q.		How will filing claims electronically benefit my office?
A.		Electronic filing is the simplest, most cost-effective way to submit your BCBSLA professional and facility claims. If your office has not been submitting claims electronically, you may not know the benefits of filing claims electronically such as: Less paperwork Shortens claim processing turnaround time. (Clean claims are paid in an average of 7 to 14 days.) Reduced administrative expense Reduced number of claims having to be re-filed Reduced errors and rejected claims Increases productivity Provides audit trail of claim activity Electronic claims can be submitted 24-hours a day, seven days a week.
Q.		Does Blue Cross and Blue Shield of Louisiana charge providers a fee for sending electronic claims?
A.		No, Blue Cross and Blue Shield of Louisiana DOES NOT charge our professional providers a fee if they decide to file their Blue Cross claims electronically. In fact, Blue Cross is a participating payor with several large clearinghouses, which means that Blue Cross pays fees so that you will not be charged for sending your Blue Cross claims electronically through their clearinghouse.
Q.		I have a medical practice system, but my vendor doesn’t offer a software application that will allow me to submit my Blue Cross claims electronically. Are there other options available for filing my claims electronically, short of selecting a new vendor?
A.		Yes, Blue Cross has developed relationships with many clearinghouses and electronic billing vendors throughout the country. These companies have systems/services, that work in conjunction with, yet separate from, your medical practice system. They will accept claims from multiple payors in a single batch transmitted to them using one telephone call from your office. When the clearinghouse opens the batch, they forward your claims to the appropriate payors including Blue Cross and Blue Shield of Louisiana.
Q.		What are the advantages to filing electronically?
A.		While there are numerous advantages to filing your Blue Cross electronically, the most prevalent are: Faster turnaround. Clean claims are paid in an average of seven to 14 days. Less paperwork for your office, allowing you to dedicate more time to other areas needing attention.
Q.		What is BCBSLA doing to become HIPAA compliant?
A.		As BCBSLA prepares to achieve HIPAA compliance, we can assure our customers and business partners that we have a plan that addresses the requirements of HIPAA. We moved quickly to facilitate our HIPAA readiness, completing an assessment in June 2000 on the legislation’s impact on every aspect of our business. Resulting from that assessment are detailed project plans that address the administration simplification provisions (transactions and data, security and privacy). Additionally, we have established an organization that can move quickly to address modifications to current and future HIPAA provisions. As part of its corporate commitment to HIPAA compliance, BCBSLA has created detailed project plans to develop and implement its capability to process the mandated standard transactions. We are finalizing our development and test schedule and will begin to solicit initial test partners shortly. We will contact each of our provider trading partners and work with them to determine an appropriate path to compliant processing. In addition, we are working to add web-based transaction capabilities and encouraging our provider trading partners to take advantage of our entire set of EDI and web capabilities. BCBSLA is also committed to complying with mandated security requirements and to provide an appropriate level of protection for its members’ health information. In particular, BCBSLA will ensure that l electronic information exchanges include appropriate authentication (such as user ID and password) and encryption mechanisms (such as SSL). Finally, BCBSLA will comply with the HIPAA privacy requirements. We have inventoried and evaluated our use and disclosure of health information and are in process of implementing required changes in our policies and procedures. In general, the Privacy Rules may not dramatically impact how BCBSLA interacts with providers; however we will make every effort to communicate any specific changes that may affect the use and disclosure of protected health information between BCBSLA and health care providers. Any questions relating to HIPAA compliance may be directed to: Blue Cross and Blue Shield of Louisiana ATTN: Lisa Decossas, HIPAA Program Director 5525 Reitz Ave. Baton Rouge, LA 70809