Coverage profile
How Substrate can help you with Capital Blue Cross of Pennsylvania
Substrate can help practices and billers with the following claims tasks for Capital Blue Cross of Pennsylvania.
Claim status
EDI 276/277The Substrate Claim Status Agent can check clearinghouse claim status for your practice with Capital Blue Cross of Pennsylvania.
Eligibility
EDI 270/271The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Capital Blue Cross of Pennsylvania.
Portal claim status
Browser automationThe Substrate Claim Status Agent can check claim status via the payer portal for Capital Blue Cross of Pennsylvania.
Frequently asked questions
Capital Blue Cross of Pennsylvania payer FAQs
How do I check claim status with Capital Blue Cross of Pennsylvania?
Providers check Capital Blue Cross of Pennsylvania via EDI 276/277 when the payer ID is accepted. Substrate automates claim status across 3,500+ payers.
Can I automate Capital Blue Cross of Pennsylvania portal follow-up?
Yes — portal retrieval is required when 276/277 is missing or stale. See payer portal automation and learn why 276/277 is not enough.
What is the payer ID for Capital Blue Cross of Pennsylvania?
The primary payer ID for Capital Blue Cross of Pennsylvania is 100952. The correct routing ID can differ by clearinghouse and transaction, so compare the 837P, 837I, 835, 270, and 276 entries before submitting.
What is the provider portal for Capital Blue Cross of Pennsylvania?
The provider portal for Capital Blue Cross of Pennsylvania is https://apps.availity.com/. Available features depend on the payer and your account.
What are the 837 payer IDs for Capital Blue Cross of Pennsylvania?
The 837P and 837I payer ID for Capital Blue Cross of Pennsylvania is 100952 via Stedi.
What is the 835 payer ID for Capital Blue Cross of Pennsylvania?
The 835 payer ID for Capital Blue Cross of Pennsylvania is 100952 via Stedi.
What is the 270 payer ID for Capital Blue Cross of Pennsylvania?
The 270 payer IDs for Capital Blue Cross of Pennsylvania are 100952 via Stedi and 100952 via Availity.
What is the 276 payer ID for Capital Blue Cross of Pennsylvania?
The 276 payer ID for Capital Blue Cross of Pennsylvania is 100952 via Stedi.
What state does Capital Blue Cross of Pennsylvania operate in?
Capital Blue Cross of Pennsylvania operates in PA.
Routing reference
Capital Blue Cross of Pennsylvania payer IDs and operating states
Use the payer ID listed for the transaction you are submitting. Verify current routing and enrollment requirements with your clearinghouse.
| Payer name | Capital Blue Cross of Pennsylvania |
|---|---|
| Operating states | PA |
| 837P professional claims payer IDStedi | 100952Enrollment required |
| 837I institutional claims payer IDStedi | 100952Enrollment required |
| 835 ERA payer IDStedi | 100952Enrollment required |
| 270 eligibility payer IDStedi | 100952Enrollment required |
| 270 eligibility payer IDAvaility | 100952Enrollment required |
| 276 claim status payer IDStedi | 100952Enrollment required |
Payer contact directory
Capital Blue Cross of Pennsylvania phone and fax numbers
Use the number associated with your task. These contacts were stated in successful eligibility responses and may apply to specific benefits, products, or departments.
- Dental phone
- (800) 613-2624CAPITAL BLUE CROSS
- Prior authorization fax
(866) 411-2573ACUTE INPATIENT REHABILITATION ADMISSION PRECERTIFICATION, SKILLED NURSING FACILITY ADMISSION PRECERTIFICATION
| Channel and number | Payer Notes | Department | Specialties |
|---|---|---|---|
fax(866) 411-2573 | Prior authorizationBenefit context: Co-Insurance |
| Hospital |
fax(866) 411-2585 | Prior authorizationBenefit context: Co-Insurance |
| Hospital |
| phone(800) 524-0149 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Dental Care |
| phone(855) 811-2218 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Pharmacy |
| phone(866) 688-2242 | Other stated context, PharmacyBenefit context: Active Coverage; Benefit context: Inactive |
| Health Benefit Plan Coverage, Pharmacy |
| phone(800) 613-2624 | DentalBenefit context: Active Coverage |
| Dental Care |
| phone(800) 216-9748 | Behavioral healthBenefit context: Active Coverage |
| Mental Health |
| phone(866) 322-1657 | Behavioral healthBenefit context: Active Coverage |
| Mental Health |
| phone(800) 452-8507 | Other stated contextBenefit context: Active Coverage |
| Hospital |
| phone(800) 664-2583 | Other stated contextBenefit context: Active Coverage |
| Health Benefit Plan Coverage |
| phone(800) 753-1276 | Other stated contextBenefit context: Active Coverage; Benefit context: Inactive |
| Health Benefit Plan Coverage |
| phone(800) 842-1768 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 905-4102 | Other stated contextBenefit context: Active Coverage |
| Vision (Optometry) |
| phone(800) 676-2583 |
|
Phone and fax numbers sourced directly from the payer response
Other aliases
Also known as
- 00361
- 100952
- 10325
- 12B61
- 23045
- 23045MA
- 24705
- 7705
- CBC01
- PABLC
- PACAPB
- Capital Blue Cross Pennsylvania
- Capital Blue Cross of Pennsylvania - Medicare Advantage
- CAPITAL BLUE CROSS