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Electronic Remittance Advice (835) Enrollment Form

INSTRUCTIONS

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.

STEP 1

Access our online Electronic Remittance Advice (835) Enrollment form

STEP 2

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.

STEP 3

Click Submit

STEP 4

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 have not received a response from us after 30 days, please call our EDI Service Desk at 1-888-334-9242 or email BravenEDI@BravenHealth.com or HorizonEDI@HorizonBlue.com as appropriate.

PLEASE NOTE

  • 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.

QUESTIONS

If you have questions, please contact the EDI Service Desk: