Electronic Remittance Advice (835) Enrollment Form
Thank you for your interest in participating in the Horizon BCBSNJ and Braven Health℠ Electronic Remittance Advice (ERA/835) programs. Below are instructions and information about the enrollment process.
Access our online Electronic Remittance Advice (835) Enrollment form
Complete the fields below in the following categories:
- Provider Information
- Provider Identifiers Information
- Provider Contact Information
- Electronic Remittance Advice Information
- Electronic Remittance Advice Clearinghouse Information
- Electronic Remittance Advice Vendor Information
- Submission Information
A glossary with details about these fields is available here.
Once we have processed your enrollment(s), our EDI team will email you a production submitter ID for Horizon BCBSNJ and/or Braven Health. Please allow up to 30 days for processing.
- If you are using a Trading Partner to perform ERA/835, your Trading Partner MUST BE an authorized Braven Health and Horizon BCBSNJ ERA Trading Partner. To obtain a list of authorized Trading Partners, please email a request to BravenEDI@BravenHealth.com or HorizonEDI@HorizonBlue.com.
If you work with a Trading Partner who is not authorized, they can request to become an authorized Braven Health/Horizon BCBSNJ ERA Trading Partner at the email addresses listed above.
- You must contact your financial institution to arrange for delivery of the CORE-required Minimum CCD+ Data Elements necessary for successful reassociation of the EFT payment with the corresponding ERA.
- Contact our EDI Service Desk if you would like to request a PDF version of our ERA Enrollment form to complete.
If you have questions, please contact the EDI Service Desk: