What is the Stedi payer ID for Highmark Wholecare?

The Stedi payer ID for Highmark Wholecare is CYZUD.

What is the primary payer ID for Highmark Wholecare?

The primary payer ID for Highmark Wholecare is 96938.

What payer IDs does Highmark Wholecare use?

In addition to its primary payer ID 96938, Highmark Wholecare uses several other payer IDs, including 96938.

What transactions does Highmark Wholecare support?

Highmark Wholecare supports the following transactions: 270/271 eligibility checks, 837D dental claims, and 835 Electronic Remittance Advices (ERAs).

What transaction types require transaction enrollment with Highmark Wholecare?

Highmark Wholecare requires transaction enrollment for 835 Electronic Remittance Advices (ERAs). Other supported transactions don't require enrollment. Stedi handles transaction enrollment steps for you.

What is transaction enrollment?

Transaction enrollment is a process required by some payers before you can send or receive certain transactions. Stedi handles this process for you.

What is a coordination of benefits (COB) check?

A COB checks determines if a member has coverage from more than one payer. Highmark Wholecare supports COB checks through Stedi.

What other names does Highmark Wholecare go by?

Highmark Wholecare is also known as Gateway Health Plan Dental, Scion Gateway Health Plan, and Skygen USA.

All payers

PAYER

Highmark Wholecare

This page contains information you can use to exchange healthcare transactions with Highmark Wholecare using Stedi.

Visit payer website

Use any of the following payer IDs to send transactions to Highmark Wholecare using Stedi APIs or SFTP. Read the docs

Primary Payer ID

Stedi Payer ID

Payer ID aliases

Coverage types

Dental

Operating states

AKALARASAZCACOCTDCDEFLGAGUHIIAIDILINKSKYLAMAMDMEMIMNMOMPMSMTNCNDNENHNJNMNVNYOHOKORPAPRRISCSDTNTXUTVAVIVTWAWIWVWY

Covered

Not covered

Supported transactions

Use Stedi to exchange the following transactions with Highmark Wholecare using APIs or SFTP. Send transactions as JSON or raw EDI files.

Eligibility & benefit verification

Supported

Eligibility checks

(270/271)

Verify member coverage and benefits by sending real-time and batch eligibility checks to Highmark Wholecare.

Not supported

Coordination of benefits checks

(COB)

Submit coordination of benefit checks to Highmark Wholecare to determine if a member has overlapping coverage with another plan and determine each payer's responsibility for paying claims.

Claims processing

Not supported

Real-time claim status

(276/277)

Check on the status of a claim previously submitted to Highmark Wholecare in real-time by sending a claim status check (276/277).

Not supported

Professional claims

(837P)

Submit professional claims to Highmark Wholecare and receive 277 claim acknowledgments asynchronously.

Not supported

Institutional claims

(837I)

Submit institutional claims to Highmark Wholecare and receive 277 claim acknowledgments asynchronously.

Supported, enrollment required

Claim payments

(835 ERA)

Receive electronic remittance advice (ERAs) from Highmark Wholecare to review full payment details.

Enrollment process type

One-click

Activation timeframe

Weeks

Supported

Dental claims

(837D)

Submit dental claims to Highmark Wholecare and receive 277 claim acknowledgments asynchronously.

Not supported

Unsolicited claim attachments

(275)

Receive unsolicited attachments for claims submitted to Highmark Wholecare.

Get started

Use Stedi's APIs to get fast and reliable connectivity to Highmark Wholecare and start processing healthcare claims and eligibility checks within minutes.

Start processing healthcare claims and eligibility checks with Stedi and Highmark Wholecare today.

Other names

Alternative known names, networks, or health plans for this payer that may appear on insurance cards, claims, or other correspondence.

Gateway Health Plan Dental
Scion Gateway Health Plan
Skygen USA

Payer Network

All payers

PAYER

Highmark Wholecare

This page contains information you can use to exchange healthcare transactions with Highmark Wholecare using Stedi.

Visit payer website

Use any of the following payer IDs to send transactions to Highmark Wholecare using Stedi APIs or SFTP. Read the docs

Primary Payer ID

Stedi Payer ID

Payer ID aliases

Coverage types

Dental

Operating states

AKALARASAZCACOCTDCDEFLGAGUHIIAIDILINKSKYLAMAMDMEMIMNMOMPMSMTNCNDNENHNJNMNVNYOHOKORPAPRRISCSDTNTXUTVAVIVTWAWIWVWY

Covered

Not covered

Supported transactions

Use Stedi to exchange the following transactions with Highmark Wholecare using APIs or SFTP. Send transactions as JSON or raw EDI files.

Eligibility & benefit verification

Supported

Eligibility checks

(270/271)

Verify member coverage and benefits by sending real-time and batch eligibility checks to Highmark Wholecare.

Not supported

Coordination of benefits checks

(COB)

Submit coordination of benefit checks to Highmark Wholecare to determine if a member has overlapping coverage with another plan and determine each payer's responsibility for paying claims.

Claims processing

Not supported

Real-time claim status

(276/277)

Check on the status of a claim previously submitted to Highmark Wholecare in real-time by sending a claim status check (276/277).

Not supported

Professional claims

(837P)

Submit professional claims to Highmark Wholecare and receive 277 claim acknowledgments asynchronously.

Not supported

Institutional claims

(837I)

Submit institutional claims to Highmark Wholecare and receive 277 claim acknowledgments asynchronously.

Supported, enrollment required

Claim payments

(835 ERA)

Receive electronic remittance advice (ERAs) from Highmark Wholecare to review full payment details.

Enrollment process type

One-click

Activation timeframe

Weeks

Supported

Dental claims

(837D)

Submit dental claims to Highmark Wholecare and receive 277 claim acknowledgments asynchronously.

Not supported

Unsolicited claim attachments

(275)

Receive unsolicited attachments for claims submitted to Highmark Wholecare.

Get started

Use Stedi's APIs to get fast and reliable connectivity to Highmark Wholecare and start processing healthcare claims and eligibility checks within minutes.

Start processing healthcare claims and eligibility checks with Stedi and Highmark Wholecare today.

Other names

Alternative known names, networks, or health plans for this payer that may appear on insurance cards, claims, or other correspondence.

Gateway Health Plan Dental
Scion Gateway Health Plan
Skygen USA