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Highmark Blue Cross Blue Shield of West Virginia

Part of Highmark Health

Regional plandentalmedicalvision
Typical enrollment turnaround
45-90 days

Summary

Highmark Blue Cross Blue Shield of West Virginia is a regional health plan, part of Highmark Health, offering dental, medical, and vision coverage operating in West Virginia. Claims route under payer ID 54828, with 15 alternate IDs in use across clearinghouses. Provider enrollment typically takes 45-90 days, with applications through Highmark BCBS WV 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 several weeks.

At a glance

Payer ID
54828Also seen as 100947, 10462, 11024, 12B28, 3589, 7131 and 9 more
Also known as
Highmark Blue Cross Blue Shield West Virginia, Highmark Blue Cross Blue Shield of West Virginia - Medicare Advantage, Mountain State Blue Cross Blue Shield West Virginia
Uses CAQH
YesApplication route: CAQH application only
Service area
WV

Clearinghouse transaction setup

Which EDI transactions this payer supports, and how long clearinghouse enrollment typically takes when it is required.

TransactionEnrollmentTypical setup
Eligibility checks (270/271)RequiredA few days
Claim status (276/277)Not requiredImmediate
Professional claims (837P)Not requiredImmediate
Institutional claims (837I)Not requiredImmediate
ERA / remittance (835)RequiredSeveral weeks

Common questions

What is the payer ID for Highmark Blue Cross Blue Shield of West Virginia?
The payer ID for Highmark Blue Cross Blue Shield of West Virginia is 54828. Alternate IDs seen across clearinghouses include 100947, 10462, 11024, 12B28.
How long does Highmark Blue Cross Blue Shield of West Virginia provider enrollment take?
Highmark Blue Cross Blue Shield of West Virginia provider enrollment typically takes 45-90 days from application to effective date. Timelines vary by state, plan, and how complete the application is.
Does Highmark Blue Cross Blue Shield of West Virginia require CAQH?
Yes. Highmark Blue Cross Blue Shield of West Virginia uses CAQH for credentialing data, so keep the provider's CAQH profile current and attested before applying.
Does Highmark Blue Cross Blue Shield of West Virginia require ERA enrollment?
Yes. Highmark Blue Cross Blue Shield of West Virginia requires a separate ERA (835) enrollment before electronic remittances flow, and setup typically takes several weeks.
What states does Highmark Blue Cross Blue Shield of West Virginia cover?
Highmark Blue Cross Blue Shield of West Virginia operates in WV. 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.