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PROVIDER eSOLUTIONS

Provider eSolutions

Provider eSolutions (formerly EDI Services) provides support to healthcare providers and practice management and electronic health record (EHR) vendors, helping to ensure that electronic transactions for our members are processed quickly and efficiently. We support all HIPAA-compliant transactions, including:

  • Eligibility and Benefits
  • Claims
  • Referrals
  • Remittance Notices

See eSolutions for Healthcare Providers for information about ways to conduct these transactions with Blue Cross.

In addition, Provider eSolutions promotes and supports the secure exchange of clinical data through standard transactions such as Direct Secure Messaging. Current clinical data exchange opportunities including care alerts, electronic medical records and lab data exchange.

Electronic Medical Records (EMRs)

MedConnect customers have the option to send medical records to Blue Cross free of charge. Sharing this clinical information can help you and our members in many ways:

  • Reduce the level of administrative burden and coding required on claims.
  • Identify patients with clinical conditions who should be enrolled in Blue Cross health and wellness programs.
  • Improve clinical alerts and information regarding gaps in patient care.
  • Reduce or eliminate the need to do manual chart extractions.
  • Impact performance in physician value-based payment programs.

If you have questions about MedConnect, contact your Provider Solutions Consultant at Ask-EDI@bcbsal.org or 205-220-6899. If you are a MedConnect customer, contact MedConnect for more information about this service.

MedConnect is an independent company.

Lab Data Exchange

Many participating laboratories send lab results to Blue Cross and Blue Shield of Alabama. This information is used in efforts to control chronic disease and guide behavioral changes for improved wellness. Lab results are also used for provider value-based incentive programs and may result in increased payment for achieving clinical effectiveness metrics.

View a list of the labs that currently send us lab results.

Information for Vendors/Clearinghouses