Pennsylvania Blue Shield: Highmark

Please follow the Enrollment Instructions below to become an electronic submitter for Pennsylvania Blue Shield Highmark.

 

Please Note: Highmark has undergone some changes that may require you to apply for a new Submitter ID and password. If you are sending to Highmark with Payer ID 54771 & Payer ID 15460, follow the instructions below. If not, please see the enrollment instructions found here: http://www.claimshuttle.com/highmark-plans

 

Required Documents for those applying for new Submitter IDs

The following documents are required enrollment documents that must be completed, signed and returned to the Highmark office prior to initiation of electronic claims submission or inquiry.

1. 5010 EDI Transaction Application to Create New Trading Partner

If the above link does not work properly, follow these steps:

To apply for a Highmark Blue Shield Submitter ID please go to the following site:
www.highmark.com/edi

-Click on Sign Up

Under the Related Links Section:

-Choose the link for “Sign up as a trading partner for 5010 claims….” Located on the right.

If you have any questions regarding any of the documents in this package, please phone the BCBS EDI Technology Support Center at 1-800-992-0246.

 

We can now process 276/277 requests (claim status). If this is a transaction you would like to utilize please make sure to enroll with the payer.

 

EDI Transaction Application

Section 1 (You are the Requester)

  • Enter your name and title

  • The name of the company you are representing

  • Enter your phone number and email address

Section 2 & 3 (You are the Trading Partner and Administrator)

  • Enter your business, group practice, or provider name

  • Complete your demographic information

  • Enter the name of the main contact person for your office

  • Enter the contact person’s email address, phone, and fax numbers

  • Enter your Tax ID number

Section 4

  • Select the Trading Partner type that best fits YOUR line of business (Professional, Institutional, or Billing Service…)

  • Select the plan types you would like to bill for (FYI: you will receive separate submitter #s for BCBS and Senior Health)

Section 5

  • Choose “Internet/FTP”

Section 6

  • For Name of Software please enter the information for the software or vendor that creates your 837 files you need ClaimShuttle to transfer for you. If you have paid for our SolAce billing software please call our support line for our SolAce software information.

Section 7

  • If you have purchased our SolAce software information please call us for testing requirements. If you use any other system you must call them to see if testing is required.

Acceptance and Submission Section

  • Please check the box to accept their terms

  • Review your information and Submit

 

Waiting for a Response

Once the complete provider enrollment packet has been received, the documents will be processed. Processing will take approximately three to five business days from the date of receipt

After processing, a confirmation will be emailed to you as notification to begin filing claims electronically. If neither confirmation nor a returned packet is received after two weeks, contact the BCBS EDI Technology Support Center at 1-866-763-3224 option 5.

 

Testing

Once you have received your Submitter ID and Password from BCBS, please call the ClaimShuttle Support Team and set an appointment for a Mailbox setup and Test Transmission to BCBS.

Please have 25 test claims ready for testing. Test files should consist of a variety of claims that represent the type of claims you will be submitting once production status is achieved. Test claims will not be processed for payment but will be validated against production files; therefore, they must contain valid patient procedure, diagnosis, and provider information.