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This document outlines the agreement between a licensed health service provider and Empire Blue Cross Blue Shield regarding electronic claims submission, including responsibilities and rights related
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How to fill out EMPIRE PROVIDER AGREEMENT FOR EMPIRE BLUE CROSS BLUE SHIELD ELECTRONIC CLAIMS SUBMISSION
01
Obtain the EMPIRE PROVIDER AGREEMENT form from the Empire Blue Cross Blue Shield website or your representative.
02
Carefully read the instructions accompanying the form to ensure you understand the requirements.
03
Fill out your practice information, including name, address, and contact details accurately.
04
Provide your National Provider Identifier (NPI) number and Tax Identification Number (TIN).
05
Indicate the types of services you provide and the specialties relevant to your practice.
06
Sign and date the agreement to confirm that all information provided is correct.
07
Send the completed agreement to the designated address provided in the instructions, either by mail or electronic submission.
Who needs EMPIRE PROVIDER AGREEMENT FOR EMPIRE BLUE CROSS BLUE SHIELD ELECTRONIC CLAIMS SUBMISSION?
01
Healthcare providers who wish to submit electronic claims to Empire Blue Cross Blue Shield.
02
Providers seeking to enroll and participate in the insurance network of Empire Blue Cross Blue Shield.
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People Also Ask about
What is BlueCross BlueShield called in NY?
Insurance: Anthem BCBS (formerly known as Empire Blue Cross Blue Shield [BCBS]) - NYC Health + Hospitals.
What is the timely filing empire for BCBS of NY?
Empire will consider reimbursement for the initial claim, when received and accepted within timely filing requirements, in compliance with federal, and/or state mandates. Empire follows the standard of: • 90 days for participating providers and facilities. 15 months for nonparticipating providers and facilities.
What is BCBS called in NY?
Insurance: Anthem BCBS (formerly known as Empire Blue Cross Blue Shield [BCBS]) - NYC Health + Hospitals.
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What is EMPIRE PROVIDER AGREEMENT FOR EMPIRE BLUE CROSS BLUE SHIELD ELECTRONIC CLAIMS SUBMISSION?
The EMPIRE PROVIDER AGREEMENT for EMPIRE BLUE CROSS BLUE SHIELD ELECTRONIC CLAIMS SUBMISSION is a contract that outlines the terms and conditions under which healthcare providers can submit electronic claims for services rendered to members of the Empire Blue Cross Blue Shield insurance plan.
Who is required to file EMPIRE PROVIDER AGREEMENT FOR EMPIRE BLUE CROSS BLUE SHIELD ELECTRONIC CLAIMS SUBMISSION?
Healthcare providers who wish to submit electronic claims for reimbursement to Empire Blue Cross Blue Shield, including physicians, hospitals, and other healthcare facilities, are required to file the EMPIRE PROVIDER AGREEMENT.
How to fill out EMPIRE PROVIDER AGREEMENT FOR EMPIRE BLUE CROSS BLUE SHIELD ELECTRONIC CLAIMS SUBMISSION?
To fill out the EMPIRE PROVIDER AGREEMENT, providers should complete all required sections of the form, including provider information, tax identification numbers, and electronic claims submission preferences. It's important to ensure all information is accurate and to provide any necessary supporting documentation.
What is the purpose of EMPIRE PROVIDER AGREEMENT FOR EMPIRE BLUE CROSS BLUE SHIELD ELECTRONIC CLAIMS SUBMISSION?
The purpose of the EMPIRE PROVIDER AGREEMENT is to facilitate efficient electronic claims submissions, ensure compliance with regulatory requirements, and delineate the rights and responsibilities of both Empire Blue Cross Blue Shield and participating providers.
What information must be reported on EMPIRE PROVIDER AGREEMENT FOR EMPIRE BLUE CROSS BLUE SHIELD ELECTRONIC CLAIMS SUBMISSION?
The information that must be reported includes provider identification details, tax identification number (TIN), service locations, contact information, and any preferences related to the electronic claims submission process.
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