Any company wishing to exchange HIPAA (X12) files with Blue Cross NC must submit the corresponding ECR form. Choose the corresponding forms based on your role as a health care provider or compensation/billing service. The trade agreement establishes the formal business relationship between a sender/recipient of electronic files and Blue Cross and Blue Shield of North Carolina. This agreement is sent electronically by the EDI analyst to new trading partners during the implementation period. To start the process, fill out the corresponding form for electronic connectivity requests and send it to eSolutions. HIPAA INFORMATIONS| ESSAI HIPAA- | Companion Guide | Examples of HIPAA documents See ECR: Information and instructions for more details. Use this form to request an electronic transfer board (835) if you need to fax the request. This form must be printed and faxed to Blue Cross NC. You can find instructions in guidelines 835 of the registration form below. Fill out an EEA (Electronic Funds Transfer) authorization form to have deposits deposited directly into your bank account. Direct payments are generally faster and safer than paper controls.

Instructions for filling out and sending the form are included. Download Use these instructions if you are a health care provider to complete an 835 registration form. . If you don`t want to exchange HIPAA (X12) files with Blue Cross NC or add a type of transaction to the transactions you`re currently entering, fill out this ECR form and send it online.