The EDI Transaction Application process includes review and acceptance of the appropriate EDI Trading Partner Agreement. Submission of the EDI Transaction Application indicates compliance with specifications set forth by Highmark for the submission of EDI transactions. This form must be completed by an authorized representative of the organization.
Complete and accurate reporting of information will insure that your authorization forms are processed in a timely manner. If you need assistance in completing the EDI Transaction Application contact your company's technical support area, your software vendor, or EDI Operations.
Upon completion of the authorization process, a Logon ID and Password will be assigned to the Trading Partner. EDI Operations will authorize, in writing, the Trading Partner to submit production EDI transactions.
Transactions Available |
4010 |
5010 |
Description |
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837 Transaction |
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Three implementations of this transaction:
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 |
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Claim Payment/Advice (Electronic Remittance) |
278 Transaction |
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July 2011 |
Two implementations of this transaction:
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276 Transaction |
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July 2011 |
Claim Status Request |
277 Transaction |
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July 2011 |
Claim Status Notification (response to 276) |
270 Transaction |
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July 2011 |
Eligibility/Benefit Inquiry |
271 Transaction |
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July 2011 |
Eligibility or Benefit Information (response to 270) |
Types of Trading Partners
Providers: Providers submit their own transactions and are professionals, institutions or organizations.
- Providers doing their own electronic billing using an approved vendor software package, (link to software vendors doc) must apply for their own Trading Partner number.
- Providers using a billing service or clearinghouse (link to billing services/clearinghouses doc) to conduct electronic billing must be affiliated with the Trading Partner number of the billing service or clearinghouse. The billing service or clearinghouse must add you to their Trading Partner agreement with Highmark.
Billing services/clearinghouses: Billing services/clearinghouses submit claims, or other transactions, on behalf of providers.
- Billing services and clearinghouses must obtain their own Trading Partner numbers for conducting electronic business with Highmark. In addition, providers must be affiliated to their Trading Partner number(s).
Software vendors: Software vendors create software for electronic commerce through electronic claims or other HIPAA-related transactions.
- Software vendors must obtain their own Trading Partner number to support software testing for electronic transactions. Software vendor Trading Partners will only be allowed to submit test transactions to Highmark.
- Software vendors that wish to submit production transactions must register as a billing service or clearinghouse.
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