Electronic Business

AZ Blue supports electronic transactions in the X12 standard HIPAA 5010 format.

  • AZ Blue requires electronic claim submission and supports the following options:

    • Availity Essentials portal
      We offer claim submission (professional, institutional, and dental) through the Availity Essentials portal at no charge to you. Your organization must be registered with Availity for access to the claim submission functionality (log in or visit Availity’s register and get started page).
    • Third-party clearinghouse
      You may also conduct electronic business through a third-party clearinghouse that conducts business in Arizona. See the list of clearinghouses already connected to AZ Blue and contact your clearinghouse to get started.

  • HIPAA Transaction Standard-AZ Blue Companion Guide (PDF)

    • 837 Institutional Healthcare Claim

      • Transfer and exchange healthcare claim billing and encounter information - Institutional claims

    • 837 Professional Healthcare Claim

      • Transfer and exchange healthcare claim billing and encounter information Professional claims

    • 837 Dental Healthcare Claim

      • Transfer and exchange healthcare claim billing and encounter information - Dental claims

    • 835 Health Care Electronic Remittance

      • Exchange of healthcare claim payment information through an electronic remittance advice (ERA)

    • 270/271 Healthcare Eligibility Benefit Inquiry and Response

      • Transfer healthcare eligibility and benefit information

    • 275 Claim Attachments (Future)

      • Additional information to support a health care claim or encounter

    • 276/277 Healthcare Claims Status and Response

      • Exchange the subscriber’s and/or dependent’s healthcare claim status information

    • 278 Healthcare Services Request for Review and Response (Future)

      • Transfer a subscriber’s and/or dependent’s healthcare referral, pre-certification and pre-authorization review, request, and response between providers and review entities

    • 834 Benefit Enrollment and Maintenance

      • Request and receive information, and transfer subscriber and/or dependent enrollment information from the sponsor of the insurance coverage, benefits, or policy to a payer

    • 820 Healthcare Premium Payments (Future)

      • Initiate group premium payment transactions with or without remittance detail

    • 999 Implementation Acknowledgement

      • Provide the results of the compliancy status

    • TA1 Interchange Acknowledgement

      • Batch or real-time transactions; sent for compliance failures at the X12 Interchange Envelope level

    • 277CA Claims acknowledgement

      • Generated for all claim files received; additional information: HIPAA Technical Report Type 3 (TR3): 5010 - Healthcare Claim Acknowledgment 277CA

  • EFT Form – Provider FAQs (PDF)
    EFT Enrollment and Changes – Instructions (PDF)

    AZ Blue encourages contracted providers to be enrolled in electronic fund transfer (EFT) for reimbursement. Starting June 1, 2024, we will use the Availity Essentials™ provider portal exclusively to receive requests for EFT enrollment and changes. Only Essentials users with “Administrator” or “EFT” roles may access the EFT enrollment form at “My Providers > Enrollment Center > Transaction Enrollment > Enroll.” The Essentials EFT process uses enhanced security features such as multi-factor authentication and includes an enrollment status dashboard to make it easy to track your request.

    If your organization is not yet registered on Essentials, visit availity.com/azblue to get started. After registering, your account administrator can quickly set up staff user accounts and assign the EFT role to the person responsible for your EFT enrollment and changes.

    Availity offers a Transaction Enrollment–Training Demo that walks you through the EFT enrollment/change process. When logged in, you can find the demo on the Transaction Enrollment page:

    Please allow 30 calendar days for EFT enrollment processing. If you have questions about the Essentials EFT enrollment/change process, contact Availity Client Services at 1-800-AVAILITY (282-4548).

  • Enroll now to receive electronic remittance advice (ERA) 835 transactions.

    ERA Enrollment Form
    ERA Enrollment Instructions

    Please allow 30 calendar days for enrollment processing. If you have questions, contact AZ Blue Integrated Customer Solutions at ICS@azblue.com.