Follow Proper Procedures for Paper Claims; Noncompliant Forms Will Be Returned
- WNY
- NENY
Wed, Apr 22, 2026
Effective May 18, 2026, Highmark will no longer accept paper claims submitted on outdated versions of the 1500 or UB-04 forms.
As stated in the Highmark Provider Manual's 6.1 Introduction to Claim Submission:
If you are using paper forms, please submit the original red claim form. Photocopies or outdated versions of the 1500 or UB-04 forms will not be accepted and will be returned to the provider. In addition, paper claims with missing, invalid, or unreadable information will be returned.
What You Need to Do
To save time and money, submit claims electronically either through Availity Essentials or Highmark’s Electronic Data Interchange (EDI). Electronic claim submission enables claims to process quickly, resulting in faster payment. In addition, submitting claims electronically eliminates printing, postage, and administrative costs.
If you must use paper, use the original, red National Uniform Claim Committee (NUCC) issued 1500 (02/12) Health Insurance Claim form. This will ensure that your claim processes correctly. In addition, paper claims with missing, invalid, or unreadable information will be returned.
Required Formats
Use the table below to determine the required format for submitting both electronic and paper claims:
|
If you submit ... |
Then use these formats ... |
|---|
Electronically |
Professional: ASC X12N 837 Health Care Claim: Professional Transaction Version 005010 (“837P”) |
Facility: ASC X12N 837 Health Care Claim: Institutional Transaction |
|
On Paper |
Professional: 1500 Health Insurance Claim Form (“1500 Claim Form”), Version 02/12 |
Facility: UB-04 (CMS 1450) Institutional Claim Form |
Additional Resources
- Highmark Provider Manual: Chapter 6, Unit 1: General Claim Submission Guidelines
- Provider Resource Center: Electronic Claims page
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