Supported Transactions
| Transaction | Status |
|---|---|
| Eligibility & benefits (270/271) | Enrollment required |
| Claim status (276/277) | Enrollment required |
| Professional claims (837P) | Not supported |
| Institutional claims (837I) | Supported |
| Dental claims (837D) | Not supported |
| Electronic remittance (ERA 835) | Enrollment required |
| Electronic funds transfer (EFT) | Not supported |
| ERA + EFT combined | Not supported |
| Coordination of benefits (271) | Not supported |
| Attachments (275) | Not supported |
Other payer IDs and names
- Payer ID
12B60 - Payer ID
2534 - Payer ID
54771W - Also listed as Highmark Blue Cross Blue Shield Pennsylvania Western
- Also listed as Highmark Blue Cross Blue Shield of Western Pennsylvania
Coverage states
Pennsylvania.
Enrollment requirements
- Electronic remittance (ERA 835): one click enrollment, typically takes weeks
Workflow Considerations
- Submit institutional claims electronically; route professional and dental claims through another billing method.
- Complete payer enrollment before using claim status, eligibility and benefits, or ERA transactions.
- Before enrollment, verify eligibility through your established non-electronic workflow and document the result in the patient’s account.
- If ERA is not active, plan to receive and post remittance information through a non-electronic workflow.
- Do not plan on EFT, combined ERA and EFT, attachments, or coordination-of-benefits transactions through this connection.
Common questions
Can I submit institutional claims to this payer electronically?
Yes. Institutional claims use the 837I transaction and are available immediately through Hero EMR.
Can I verify eligibility and benefits electronically?
Yes, after the practice completes this payer’s enrollment process. Eligibility and benefits use 270/271 transactions, but coordination-of-benefits transactions are not available.
Can I check claim status electronically?
Yes, claim status is supported with 276/277 transactions after payer enrollment is completed. Until enrollment is complete, use the practice’s existing non-electronic process.
Does this payer support ERA or EFT?
ERA 835 is supported after enrollment, but EFT and combined ERA plus EFT are not available through this connection.
Run this payer inside Hero EMR
Hero EMR submits claims, checks eligibility, and posts remittances automatically for the payers it connects to. The first physician is free.
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