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Highmark of Pennsylvania

Highmark of Pennsylvania

This page contains information you can use to exchange healthcare transactions with Highmark of Pennsylvania using Stedi.
Use any of the following payer IDs to send transactions to Highmark of Pennsylvania using Stedi APIs or SFTP. Read the docs
Primary Payer ID
54771
Stedi Payer ID
GUFCO
Payer ID aliases
10046, 10524, 2413, 54771, 95462, PABCBS, PABLS, SB865, SB865MA
Parent group
Highmark Group
Coverage types
Dental, Medical, Vision

Supported transactions

Use Stedi to exchange the following transactions with Highmark of Pennsylvania using APIs or SFTP. Send transactions as JSON or raw EDI files.
Eligibility & benefit verification
Supported, enrollment required

Eligibility checks

(270/271)
Verify member coverage and benefits by sending real-time and batch eligibility checks to Highmark of Pennsylvania.
Supported

Coordination of benefits checks

(COB)
Submit coordination of benefit checks to Highmark of Pennsylvania to determine if a member has overlapping coverage with another plan and determine each payer's responsibility for paying claims.
Claims processing
Supported, enrollment required

Real-time claim status

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

Professional claims

(837P)
Submit professional claims to Highmark of Pennsylvania and receive 277 claim acknowledgments asynchronously.
Not supported

Institutional claims

(837I)
Submit institutional claims to Highmark of Pennsylvania and receive 277 claim acknowledgments asynchronously.
Supported, enrollment required

Claim payments

(835 ERA)
Receive electronic remittance advice (ERAs) from Highmark of Pennsylvania to review full payment details.
Not supported

Dental claims

(837D)
Submit dental claims to Highmark of Pennsylvania and receive 277 claim acknowledgments asynchronously.
Not supported

Unsolicited claim attachments

(275)
Receive unsolicited attachments for claims submitted to Highmark of Pennsylvania.
Get started
Use Stedi's APIs to get fast and reliable connectivity to Highmark of Pennsylvania and start processing healthcare claims and eligibility checks within minutes.
Start processing healthcare claims and eligibility checks with Stedi and Highmark of Pennsylvania today.
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Other names
Alternative known names, networks, or health plans for this payer that may appear on insurance cards, claims, or other correspondence.
  • Highmark Blue Cross Blue Shield
  • Highmark Blue Cross Blue Shield Pennsylvania
  • Highmark Blue Cross Blue Shield Pennsylvania Professional
  • Highmark Blue Shield
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