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View requirements for Local Plan and BlueCard Out-of-Area members.

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Electronic Data Interchange (EDI) and ERA(only) Registration Form

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Below is information on how you can register to submit electronically to Empire.   
Please complete the required registration form and submit by fax or email:  

Empire BlueCross BlueShield
Fax: (877) 287-1410
Email: EDI_NY_ENROLLMENT@EMPIREBLUE.COM

 

EDI Registration Form
This form is used to record submitter and software vendor information and it is required to establish a submitter ID. Only one form is needed per facility, practice or group. Alternatively, only one form is needed per trading partner.

PDF Format

 
 
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