Coverage profile
How Substrate can help you with Highmark of Pennsylvania
Substrate can help practices and billers with the following claims tasks for Highmark of Pennsylvania.
Claim status
EDI 276/277The Substrate Claim Status Agent can check clearinghouse claim status for your practice with Highmark of Pennsylvania.
Eligibility
EDI 270/271The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Highmark of Pennsylvania.
Portal claim status
Browser automationThe Substrate Claim Status Agent can check claim status via the payer portal for Highmark of Pennsylvania.
2027 maternity billing research
When does Highmark of Pennsylvania change OB/GYN billing?
The CPT maternity code changes take effect 2027-01-01, but Highmark has not announced an operational billing change and is still reviewing implementation.
- Transition start
- Not published
- Billing start
- Not published
- Published
- 2026-07-01
- Current As Of
- August 2026
Scope: payer-family guidance across named Highmark markets
Maternity billing changes for 2027. Verify the payer source before claim submission.
Frequently asked questions
Highmark of Pennsylvania payer FAQs
How do I check claim status with Highmark of Pennsylvania?
Providers check Highmark of Pennsylvania via EDI 276/277 when the payer ID is accepted. Substrate automates claim status across 3,500+ payers.
Can I automate Highmark 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 Highmark of Pennsylvania?
The primary payer ID for Highmark of Pennsylvania is 54771. 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 Highmark of Pennsylvania?
The provider portal for Highmark of Pennsylvania is https://apps.availity.com/. Available features depend on the payer and your account.
What is the 837P payer ID for Highmark of Pennsylvania?
The 837P payer ID for Highmark of Pennsylvania is 54771 via Stedi.
What is the 835 payer ID for Highmark of Pennsylvania?
The 835 payer ID for Highmark of Pennsylvania is 54771 via Stedi.
What is the 270 payer ID for Highmark of Pennsylvania?
The 270 payer IDs for Highmark of Pennsylvania are 54771 via Stedi and 54771 via Availity.
What is the 276 payer ID for Highmark of Pennsylvania?
The 276 payer IDs for Highmark of Pennsylvania are 54771 via Stedi and 54771 via Availity.
What state does Highmark of Pennsylvania operate in?
Highmark of Pennsylvania operates in PA.
Routing reference
Highmark 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 | Highmark of PennsylvaniaSource: Substrate payer directory · last refreshed |
|---|---|
| Operating states | PASource: Substrate payer directory · last refreshed |
| 837P professional claims payer IDStedi | 54771Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 835 ERA payer IDStedi | 54771Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDStedi | 54771Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDAvaility | 54771Enrollment requiredSource: Availity payer catalog · catalog dated · matched by payer ID |
| 276 claim status payer IDStedi | 54771Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 276 claim status payer IDAvaility | 54771Enrollment requiredSource: Availity payer catalog · catalog dated · matched by payer ID |
Routing sources and verification
- Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Last refreshed .
- Stedi payer catalogMatched by payer ID; matched record: Highmark of Pennsylvania. Source dated .PrimaryPayerId is used as the transaction payer ID when the corresponding Stedi support flag is true.Open current Stedi reference ↗
- Availity payer catalogMatched by payer ID; matched record: HIGHMARK BCBS PENNSYLVANIA PROFESSIONAL. Source dated .The attached API workbook supplies 270 and 276 payer IDs only. It does not supply 837P, 837I, or 835 IDs.Open current Availity reference ↗
- United Clearinghouse payer catalogMatched by payer name; matched record: Highmark of Pennsylvania. The source did not provide a publication date.The attachment supplies payer names and states only; it does not contain transaction-specific payer IDs.Open current United Clearinghouse reference ↗
Clearinghouse payer IDs are transaction-specific and can change. Confirm the current payer list and the member’s ID card before submission.
Payer contact directory
Highmark 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.
- Payer phone
- (800) 327-6716HIGHMARK OF PENNSYLVANIA
- Payer fax
(888) 282-1321HIGHMARK OF PENNSYLVANIA
| Channel and number | Payer Notes | Department | Specialties |
|---|---|---|---|
fax(888) 282-1321 |
| ||
| phone(800) 321-0935 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Dental Care |
| phone(800) 441-9188 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Hospital, Hospital - Inpatient |
| phone(800) 987-8357 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Pharmacy |
| phone(833) 958-2804 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Pharmacy |
| phone(800) 305-4271 | Utilization managementBenefit context: Co-Insurance |
| Hospital |
| phone(866) 470-6244 | Utilization managementBenefit context: Co-Insurance |
| Hospital |
| phone(484) 862-3506 | Other stated contextBenefit context: Active Coverage |
| Hospital |
| phone(800) 344-5245 | Other stated contextBenefit context: Active Coverage |
| Hospital |
| phone(800) 424-8270 | Other stated contextBenefit context: Coverage Basis |
| |
| phone(800) 452-8507 | Other stated contextBenefit context: Active - Pending Investigation; Benefit context: Active Coverage |
| Hospital |
| phone(800) 480-6658 | Other stated contextBenefit context: Active Coverage |
| Hospital |
| phone(800) 664-2583 | Other stated contextBenefit context: Active Coverage |
| Health Benefit Plan Coverage |
| phone(855) 550-3733 | Other stated contextBenefit context: Active Coverage |
| Hospital |
| phone(866) 803-8002 | Other stated contextBenefit context: Coverage Basis |
| |
| phone(800) 327-6716 |
| ||
| phone(800) 676-2583 |
|
Phone and fax numbers sourced directly from the payer response
Other aliases
Also known as
- 100338
- 10046
- 100900
- 10264
- 10524
- 2413
- 35145
- 54771
- 95462
- AJOXG
- PABCBS
- PABLS
- SB865
- SB865MA
- SZXAY
- First Priority Life Insurance Company (FPLIC) Out-of-Area Claims
- Highmark Blue Cross Blue Shield
- Highmark Blue Cross Blue Shield Pennsylvania
- Highmark Blue Cross Blue Shield Pennsylvania Professional
- Highmark Blue Shield
- Highmark of Pennsylvania - Medicare Advantage
- Keystone Health Plan West - Community Blue HMO
- BCBSPA
- HIGHMARK BCBS PENNSYLVANIA PROFESSIONAL
- HIGHMARK BCBS PENNSYLVANIA