EDI Enrollment

Electronic Remittance Advice Registration (835)

To register for Electronic Remittance Advices, simply complete and submit our ERA Enrollment Form. ERAs are routed by Tax ID and cannot be split among different clearinghouses. Once registered, your ERA information is also available via NaviNet, our provider portal.

Electronic Healthcare Claim Enrollment (837I, 837P, 837D)

If you are submitting claims through an approved clearinghouse/vendor, there is no EDI enrollment required and you will not need to submit the standard agreement and/or registration forms. As long as you have successfully completed the Credentialing Process, you can submit claims through any clearinghouse you prefer. For more information on the Credentialing Process, please visit our Credentialing page.

If you elect to submit claims directly rather than through a clearinghouse, please follow these steps:

One of the Trading Partner Agreements will be signed by a representative of BCBSNE and returned to you. An EDI Account Executive will then contact you regarding the certification and testing process for your electronic transactions. Once you are certified as a Trading Partner and transaction testing is complete, you will be approved to send files for processing.


Providers interested in our Electronic Funds Transfer service are able to complete and return an EFT Enrollment Form. EFT-related requests will be processed through our Health Network Administration Department.



The percentage of the bill you pay after your deductible has been met.


A fixed amount you pay when you get a covered health service.

Tiered benefit plan

A health care plan featuring multiple levels of benefits based on the network status of a particular provider. 


The annual amount you pay for covered health services before your insurance begins to pay.

emergency care services

Any covered services received in a hospital emergency room setting.


Includes behavioral health treatment, counseling, and psychotherapy

in-network provider

A provider contracted by your insurance company to accept an agreed upon payment for covered services. 

OUT-OF-network provider

A term for providers that aren’t contracting with your insurance company. (Your out-of-pocket costs will tend to be more expensive if you go to an out-of-network provider.)


Your expenses for medical care that aren’t reimbursed by insurance, including deductibles, coinsurance and co-payments.


If you can afford health insurance, but choose not to buy it, you must have a health coverage exemption or pay a tax penalty on your federal income tax return.


The amount you pay to your health insurance company each month. 

Preventive services

Health care services that focus on the prevention of disease and health maintenance.


Services and devices to help you recover if you are injured or have surgery. This includes physical, occupational and speech therapy.

special enrollment period

The time after the Open Enrollment Period when you can still purchase health insurance only if you have a qualifying life event (losing other health coverage, having a baby, getting married, moving).


A physician who has a majority of his or her practice in fields other than internal or general medicine, obstetrics/gynecology, pediatrics or family practice.