Blue Cross Blue Shield of Oklahoma
HIPAA 834 format, 5010 platform
Client Level Configurations
- ISA06: Interchange Sender ID-Use sender's identification. Carrier has specific required values that they will provide.
- GS02, GS03: Carrier provided values
- GS06: Group Control Number Assigned by Sender must match GE02 in footer (required to be 1-9 digits)
- REF*38 is optional and carrier will provide required values if needed.
- N102: Plan Sponsor Name
- N104: Plan Sponsor Tax ID
- This Loop is optional. Carrier client level structure will indicate if this is needed
- Most REF segments except REF*OF are listed as optional in this loop for this carrier. The carrier will indicate when they require an optional loop
- These loops are optional and will be used based on the carrier requirements. See client level structure for details
- HD04-Plan Coverage Description: Carrier requires this and the required values are case based. Refer to client level group structure for exact requirements
- REF*1L-This is required. Carrier will provide group specific structure with required values.
Loops 2310, 2320
- These loops are optional. Carrier client level structure will indicate if this is needed
- GE02: Group Control Number Assigned by Sender must be the same as GS06
- Carrier requests Loop2700 (Reporting Loop) but that is not currently supported by Employee Navigator
- No PGP encryption key was provided. Carrier uses a SFTP protocol for transmission (Secure)
- Terminated records are set to drop from this carrier’s file feeds at 14 days past the termination date
The carrier has not provided their Open Enrollment requirements. Once that is provided this document will be updated. Please refer to the carrier if you have questions regarding their open enrollment/EDI process