Coverage profile
Work Highmark Pennsylvania Western Region across every published route
Use the current payer record to choose the right claim-status, eligibility, portal, phone, or appeals workflow. Substrate only marks routes that are published for this payer.
Claim status
EDI 276/277The Substrate Claim Status Agent can check clearinghouse claim status for your practice with Highmark Pennsylvania Western Region.
Eligibility
EDI 270/271The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Highmark Pennsylvania Western Region.
Other aliases
Also known as
- 12B60
- 12B81
- 2534
- 54771W
- Highmark Blue Cross Blue Shield Pennsylvania Western
- Highmark Blue Cross Blue Shield of Western Pennsylvania
- HIGHMARK BLUECROSS BLUESHIELD
- HIGHMARK BCBS PENNSYLVANIA WESTERN
- HIGHMARK BC PENNSYLVANIA WESTERN
2027 maternity billing research
When does Highmark Pennsylvania Western Region change OB/GYN billing?
Highmark reports an industry-wide maternity coding model effective January 1, 2027 and is reviewing implementation. This notice supplies no Highmark-specific claim-submission rules or payer billing implementation date.
- Transition start
- Not published
- Billing start
- Not published
- Published
- 2026-07-01
- Current As Of
- August 2026
Scope: General maternity-services awareness notice associated with the Highmark Blue Cross Blue Shield WPA/NEPA regional brand. Individual Western Pennsylvania medical products are not enumerated; Dental policies are not addressed.
Maternity billing changes for 2027. Verify the payer source before claim submission.
Frequently asked questions
Highmark Pennsylvania Western Region payer FAQs
How do I check claim status with Highmark Pennsylvania Western Region?
Providers check Highmark Pennsylvania Western Region via EDI 276/277 when the payer ID is accepted. Substrate automates claim status across 3,500+ payers.
What is the payer ID for Highmark Pennsylvania Western Region?
The primary payer ID for Highmark Pennsylvania Western Region is 12B81. 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 837I payer ID for Highmark Pennsylvania Western Region?
The 837I payer ID for Highmark Pennsylvania Western Region is 12B81 via Stedi.
What is the 835 payer ID for Highmark Pennsylvania Western Region?
The 835 payer ID for Highmark Pennsylvania Western Region is 12B81 via Stedi.
What is the 270 payer ID for Highmark Pennsylvania Western Region?
The 270 payer ID for Highmark Pennsylvania Western Region is 12B81 via Stedi.
What is the 276 payer ID for Highmark Pennsylvania Western Region?
The 276 payer ID for Highmark Pennsylvania Western Region is 12B81 via Stedi.
What state does Highmark Pennsylvania Western Region operate in?
Highmark Pennsylvania Western Region operates in PA.
Routing reference
Highmark Pennsylvania Western Region 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 Pennsylvania Western RegionSource: Substrate payer directory · data last changed |
|---|---|
| Operating states | PASource: Substrate payer directory · data last changed |
| 837I institutional claims payer IDStedi | 12B81Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 835 ERA payer IDStedi | 12B81Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDStedi | 12B81Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 276 claim status payer IDStedi | 12B81Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
Routing sources and verification
- Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Data last changed ; checked .Open payer website ↗
- Stedi payer catalogMatched by payer ID; matched record: Highmark Pennsylvania Western Region. Source dated .PrimaryPayerId is used as the transaction payer ID when the corresponding Stedi support flag is true.Open current Stedi reference ↗
Clearinghouse payer IDs are transaction-specific and can change. Confirm the current payer list and the member’s ID card before submission.