Provider Transactions

270 Transaction

Eligibility/Benefit Inquiry

271 Transaction

Eligibility or Benefit Information (response to 270)

276 Transaction

Claim Status Request

277 Transaction

Claim Status Notification (response to 276)

278 Transaction

Two implementations of this transaction:

• Services Review – Request for Review
  (Referral/Authorization Request)
• Services Review – Response to Request for Review

837 Transaction

Three implementations of this transaction:

• Institutional
• Professional
• Dental

Note: Dental transactions (837Ds) for Highmark products must be sent to Highmark's dental associate, United Concordia Companies Inc (UCCI). To receive authorization to submit EDI transactions to UCCI, you must contact Dental Electronic Services at (800) 633-5430.

835 Transaction

Claim Payment/Advice (Electronic Remittance)

277 Acknowledgement

Claim Acknowledgement

997 / 999 Transaction

Functional Group Acknowledgement

Employer/Sponsor Transactions

834 Transaction

Benefit Enrollment and Maintenance

820 Transaction

Premium Payment