ANSI 837 - Florida Blue - BCBSF

Florida Blue 837 P Companion Guide 2012III.General InformationEDI Technical Assistance for Availity Users:Your first point of contact is the Availity Customer Support Team. If necessary, this team will triageyour issue to Florida Blue. Availity Customer Support can be reached at 1-800-AVAILITY (282-4548).IV.EDI Processing and AcknowledgementsIMPORTANT NOTE: If you submit your transactions through Availity, please refer to the Availity EDIGuide located on the Availity website at www.availity.com for processing and acknowledgementsinformation. The purpose of this section is to outline Florida Blue processes for handling the initialprocessing of incoming files and the electronic acknowledgment generation process.EDI Processing HoursThe 837 Health Care Professional Claim transaction files can be transmitted seven days a week, 24hours a day. Standard EDI processing hours are Monday through Friday, 12:01 a.m. to 6:00 p.m.Files received after 6:00 p.m. will be processed the next business day. Files are not processed onweekends or company holidays.TA1 Interchange Acknowledgement TransactionAll X12 file submissions are pre-screened upon receipt to determine if the ISA or IEA segments arereadable. If errors are found, a TA1 response transaction will be sent to notify the trading partnerthat the file could not be processed provided the file contains a code value of 1 in the ISA14 of theinbound transaction. No TA1 response transaction will be sent for error-free files.Once Florida Blue determines that the file is readable, validation is performed on the ISA and IEAloop information. If these segments have a non-standard structure, the file will receive a full filereject and the TA1 response transaction will be sent to the trading partner, provided the filecontains a code value of 1 in the ISA14.999 Functional Acknowledgement TransactionIf the file submission passes the ISA/IEA pre-screening above, it is then checked for ASC X12 syntaxand HIPAA compliance errors. When the compliance check is complete, a 999 Acknowledgementwill be sent to the trading partner informing them if the file has been accepted or rejected. Ifmultiple transaction sets (ST-SE) are sent within a functional group (GS-GE), the entire functionalgroup (GS-GE) will be rejected when an ASC X12 or HIPAA compliance error is found.81 Availity, LLC Is a multi-payer joint venture company. For more information or to register, visit Availity’s website atwww.availity.com.900-3398-1112005010X222A1Florida Blue December 2012