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Medical Policy, Clinical UM Guidelines, and Pre-Cert Requirements
View requirements for Local Plan and BlueCard Out-of-Area members.

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Empire BlueCross BlueShield Commercial Business

As federally mandated, Health plans are required by law to have the ability to send and receive HIPAA-compliant transactions. Specific Empire business requirements are further clarified in the following Transaction Specific Companion Documents, supplemental to HIPAA Implementation Guides/TR3s, for efficient processing through Empire systems.  
5010 Companion Guide 
What’s Changing for 5010 
Section A – EDI User Guide  
834 User Guide (for Employer Groups)
User Guide (all transactions except 834)
Communication Protocol 
EDI HTTPS File Upload
Section B – Transaction Specific Companion Documents  
III. Electronic Guides  
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