BCBS Prefix SMI

Highmark Blue Cross Blue Shield Delaware

Delaware • Traditional Indemnity, PPO, Medicare Advantage

Billing essentials

Provider phone: (800) 452-8507
Electronic payer ID: 58379
Claims mailing address: P.O. Box 1991, Wilmington, DE 19801-1368
Timely filing limit: 180 daysCompare all plans
Prior authorization phone: (800) 452-8507
Provider website: https://www.highmark.com

Coverage under prefix SMI

Traditional Indemnity

Under this indemnity prefix, the member has fee-for-service coverage. There is no provider network, no referral requirement, and no primary care physician gatekeeper. Claims are processed based on the plan's fee schedule. While less common than managed care plans, indemnity coverage is still offered by some BCBS companies.

PPO

Under this PPO prefix, members are covered for both in-network and out-of-network care. The plan pays a higher percentage of allowed charges when members use participating providers. No gatekeeper or primary care referral is required. Verify the member's specific benefits for cost-sharing details.

Medicare Advantage

This prefix includes Medicare Advantage coverage. MA plans follow CMS guidelines for timely filing (365 days from date of service), which may differ from the commercial plan's deadline. The payer ID for Medicare Advantage claims may differ from the standard commercial payer ID. Verify before submitting.