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Highmark Wholecare

Primary payer ID
10629TCompare transaction IDs ↓
Last successful claim statusWithin the past weekObserved across Substrate's claim-status network.
SupportedEDI 276/277EDI 270/271

Is your practice experiencing high volumes of no response claims or denials from Highmark Wholecare? Try Substrate Denial Intelligence here -->.

Coverage profile

How Substrate can help you with Highmark Wholecare

Substrate can help practices and billers with the following claims tasks for Highmark Wholecare.

Claim status

EDI 276/277

The Substrate Claim Status Agent can check clearinghouse claim status for your practice with Highmark Wholecare.

Available

Eligibility

EDI 270/271

The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Highmark Wholecare.

Available

Frequently asked questions

Highmark Wholecare payer FAQs

How do I check claim status with Highmark Wholecare?

Providers check Highmark Wholecare 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 Wholecare?

The primary payer ID for Highmark Wholecare is 10629T. The correct routing ID can differ by clearinghouse and transaction, so compare the 837P, 837I, 835, 270, and 276 entries before submitting.

What are the 837 payer IDs for Highmark Wholecare?

The 837P and 837I payer ID for Highmark Wholecare is 10629T via Stedi.

What is the 835 payer ID for Highmark Wholecare?

The 835 payer ID for Highmark Wholecare is 10629T via Stedi.

What is the 270 payer ID for Highmark Wholecare?

The 270 payer IDs for Highmark Wholecare are 10629T via Stedi and 10629T and 25169 via Availity.

What is the 276 payer ID for Highmark Wholecare?

The 276 payer IDs for Highmark Wholecare are 10629T via Stedi and 10629T and 25169 via Availity.

What state does Highmark Wholecare operate in?

Highmark Wholecare operates in PA.

Resource library

Routing reference

Highmark Wholecare 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.

Highmark Wholecare payer name, operating states, and transaction-specific payer IDs
Payer nameHighmark WholecareSource: Substrate payer directory · last refreshed
Operating statesPASource: United Clearinghouse payer catalog · matched by payer name
837P professional claims payer IDStedi10629TSource: Stedi payer catalog · catalog dated · matched by payer ID
837I institutional claims payer IDStedi10629TSource: Stedi payer catalog · catalog dated · matched by payer ID
835 ERA payer IDStedi10629TEnrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID
270 eligibility payer IDStedi10629TSource: Stedi payer catalog · catalog dated · matched by payer ID
270 eligibility payer IDAvaility10629T25169Source: Availity payer catalog · catalog dated · matched by payer ID
276 claim status payer IDStedi10629TSource: Stedi payer catalog · catalog dated · matched by payer ID
276 claim status payer IDAvaility10629T25169Source: 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 .Open payer website ↗
  • Stedi payer catalogMatched by payer ID; matched record: Highmark Wholecare. 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 records: GATEWAY HEALTH PLAN, GATEWAY HEALTH PLAN MEDICAID PENNSYLVANIA, HIGHMARK WHOLECARE (MEDICAID). 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 Wholecare. 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 Wholecare 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) 685-5205HIGHMARK WHOLECARE (FKA GATEWAY HP)
Highmark Wholecare payer phone and fax directory
Channel and numberPayer NotesDepartmentSpecialties
phone(800) 685-5205
  • Gateway Health Plan
  • HIGHMARK WHOLECARE (FKA GATEWAY HP)

Phone and fax numbers sourced directly from the payer response

Other aliases

Also known as

  • 10629T
  • 25169
  • 4569
  • 8472
  • GATHP
  • GHPMCD
  • Gateway Health Plan Medicaid Pennsylvania
  • GATEWAY HEALTH PLAN
  • GATEWAYHP
  • HIGHMARK WHOLECARE (MEDICAID)