Capital Blue Cross of Pennsylvania
Part of Capital Blue Cross
Summary
Capital Blue Cross of Pennsylvania is a regional health plan, part of Capital Blue Cross, offering dental, medical, and vision coverage operating in Pennsylvania. Claims route under payer ID 100952, with 10 alternate IDs in use across clearinghouses. Provider enrollment typically takes 45-90 days, with applications through Capital Blue Cross Provider Portal, and CAQH is used for credentialing data. Through clearinghouses it supports eligibility checks, claim status inquiries, professional claims, institutional claims, and electronic remittance (ERA); ERA enrollment is required and takes a few days.
At a glance
- Payer ID
100952Also seen as 00361, 10325, 12B61, 23045, 23045MA, 24705 and 4 more- Also known as
- Capital Blue Cross Pennsylvania, Capital Blue Cross of Pennsylvania - Medicare Advantage
- Uses CAQH
- YesApplication route: CAQH application only
- Service area
- PA (central)
Clearinghouse transaction setup
Which EDI transactions this payer supports, and how long clearinghouse enrollment typically takes when it is required.
| Transaction | Enrollment | Typical setup |
|---|---|---|
| Eligibility checks (270/271) | Required | A few days |
| Claim status (276/277) | Required | A few days |
| Professional claims (837P) | Required | A few days |
| Institutional claims (837I) | Required | A few days |
| ERA / remittance (835) | Required | A few days |
Common questions
- What is the payer ID for Capital Blue Cross of Pennsylvania?
- The payer ID for Capital Blue Cross of Pennsylvania is 100952. Alternate IDs seen across clearinghouses include 00361, 10325, 12B61, 23045.
- How long does Capital Blue Cross of Pennsylvania provider enrollment take?
- Capital Blue Cross of Pennsylvania provider enrollment typically takes 45-90 days from application to effective date. Timelines vary by state, plan, and how complete the application is.
- Does Capital Blue Cross of Pennsylvania require CAQH?
- Yes. Capital Blue Cross of Pennsylvania uses CAQH for credentialing data, so keep the provider's CAQH profile current and attested before applying.
- Does Capital Blue Cross of Pennsylvania require ERA enrollment?
- Yes. Capital Blue Cross of Pennsylvania requires a separate ERA (835) enrollment before electronic remittances flow, and setup typically takes a few days.
- What states does Capital Blue Cross of Pennsylvania cover?
- Capital Blue Cross of Pennsylvania operates in PA (central). Coverage can differ by plan and product line, so confirm the specific plan before you file.
Compiled from public payer resources and clearinghouse catalogs. Details change often, so confirm with the payer before relying on them. Spot something out of date? Tell us and we will fix it.