The following resources are available to help you conduct EDI business successfully with AmeriHealth. Please also review our EDI Frequently Asked Questions.

Payer ID Grids

AmeriHealth maintains multiple payer IDs to represent our different product lines. Click the links below for detailed information on professional and facility payer ID codes:

Claim Resolution Documents

The following documents provide guidance on resolving claim rejections:

EFT/ERA Resolution Procedures

If an EFT payment has not been received after 4 business days of receipt of the corresponding ERA/835 file, you can research it by contacting AmeriHealth through Provider eBusiness Inquiry form at:
For New Jersey :
For Pennsylvania :

If an ERA/835 file has not been received after 4 business days of receipt of the corresponding EFT payment, you can research it by contacting EDI Operations at 1-800-992-0246.

Companion Guides

The following documents provide guidelines for conducting EDI transactions with AmeriHealth. The documents supplement the HIPAA-mandated 5010 ASC X12 Implementation Guides and addenda with clarifications and payer-specific usage and content requirements.

Sample Transactions

The following are de-identified samples of EDI transactions that trading partners may conduct with AmeriHealth. Note that sample transactions are formatted with carriage returns for ease of review.

Trading Partner Agreements

Trading partners are required to execute a Trading Partner Agreement with Highmark in order to conduct EDI business with AmeriHealth via the Highmark Gateway. Please select the agreement that is appropriate to your type of organization:

Communication Standards

This document addresses the Internet file transfer options available for Secure Transport, Highmark's secure file transfer protocol (SFTP) server. Trading partners must meet these technical requirements in order to connect to the Highmark Gateway.

Electronic Funds Transfer (EFT)

For information regarding electronic funds transfer including registration, maintenance and issue resolution, please visit the EFT page on AmeriHealth’s Provider News Center.

EFT Resources