Highmark of Pennsylvania
Part of Highmark Health
Summary
Highmark of Pennsylvania is a regional health plan, part of Highmark Health, offering dental, medical, and vision coverage operating in 4 states. Claims route under payer ID 54771, with 11 alternate IDs in use across clearinghouses. Provider enrollment typically takes 45-90 days, with applications through Highmark Provider Portal, and CAQH is used for credentialing data. Through clearinghouses it supports eligibility checks, claim status inquiries, professional claims, and electronic remittance (ERA); ERA enrollment is required and takes several weeks.
At a glance
- Payer ID
54771Also seen as 10046, 100900, 10264, 10524, 2413, 95462 and 5 more- Also known as
- First Priority Life Insurance Company (FPLIC) Out-of-Area Claims, Highmark Blue Cross Blue Shield, Highmark Blue Cross Blue Shield Pennsylvania, Highmark Blue Cross Blue Shield Pennsylvania Professional, Highmark Blue Shield
- Uses CAQH
- YesApplication route: CAQH application only
- Service area
- PA, WV, DE, NY (western)
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) | Not required | Immediate |
| ERA / remittance (835) | Required | Several weeks |
Common questions
- What is the payer ID for Highmark of Pennsylvania?
- The payer ID for Highmark of Pennsylvania is 54771. Alternate IDs seen across clearinghouses include 10046, 100900, 10264, 10524.
- How long does Highmark of Pennsylvania provider enrollment take?
- Highmark 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 Highmark of Pennsylvania require CAQH?
- Yes. Highmark of Pennsylvania uses CAQH for credentialing data, so keep the provider's CAQH profile current and attested before applying.
- Does Highmark of Pennsylvania require ERA enrollment?
- Yes. Highmark of Pennsylvania requires a separate ERA (835) enrollment before electronic remittances flow, and setup typically takes several weeks.
- What states does Highmark of Pennsylvania cover?
- Highmark of Pennsylvania operates in PA, WV, DE, NY (western). Coverage can differ by plan and product line, so confirm the specific plan before you file.
Related payers
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.