Blue Cross Blue Shield

BizTalk EDI Assistance Optimizes Efficiency through HIPAA Compliance

Since 1929, Blue Cross Blue Shield (BCBS) companies have provided healthcare coverage to members. Blue Cross Blue Shield offers a personalized approach to healthcare based on the needs of the communities where their members live and work. BCBS companies work closely with hospitals and doctors in the communities they serve to provide quality, affordable healthcare. More than 96 percent of hospitals and 93 percent of specialists and doctors contract with BCBS companies. They insure over 106 million members in all 50 states, Washington, D.C. and Puerto Rico, which ends up being one in every three Americans-more than any other insurer.



Blue Cross Blue Shield approached Innovative Architects to assist with BizTalk EDI use to ensure HIPAA compliance.

The Innovative Architects BizTalk Consulting Team helped BCBS automate HIPAA business processes and optimize efficiencies. Through a migration to BizTalk 2013, BCBS could now use a framework that allowed seamless EDI transfers that met HIPAA compliance and allowed for easy conversion. While EDI is built into BizTalk, implementing and maximizing its use can be difficult when facing strict regulations and standards.   The new framework for BCBS could be easily modified and deployed to accommodate HIPAA rule changes regarding processes.

Additionally, IA assisted setting up new trading partners for BCBS from start to finish.  Throughout the process, the IA team also boosted security measures, ensuring that BCBS had a trusted and safe relationship with its trading partners.

Benefits
  • EDI efficiency
  • Increased employee efficiency and time saved
  • Ability to meet HIPAA compliance requiremnts
  • IA available for BizTalk and EDI training
  • Easy to access and maintain
  • Modifiable and easy to deploy to meet rule changes
  • Tightened security measures
Blue Cross Blue Shield


The BizTalk support offered by Innovative Architects has been instrumental in meeting the needs of BCBS and our expanding market. Meeting HIPAA compliance is a frequent setback, but utilizing EDI and X12 has allowed BCBS to transfer all components with ease and security. The consultants at IA were knowledgeable and efficient, and we are very satisfied with the results. We would love to do business with IA in the future, and we hope to expand our knowledge of BizTalk through them.
-Joshua Lao, CFO, Blue Cross Blue Shield North Carolina