BCBS Prefix ZPW

Highmark Blue Cross Blue Shield of West Virginia

West Virginia • POS, Medicare Advantage, PPO

Billing essentials

Provider phone: (866) 459-4418
Electronic payer ID: RGA01
Claims mailing address: P.O. Box 870, Morgantown, WV 26507
Timely filing limit: 365 daysCompare all plans
Prior authorization phone: (866) 459-4418
Provider website: https://providers.highmark.com/

Coverage under prefix ZPW

POS

POS coverage under this prefix operates on a tiered system. Tier 1 (in-network with referral) provides the highest coverage. Tier 2 (in-network without referral) provides moderate coverage. Tier 3 (out-of-network) provides the lowest coverage. Verify which tier applies before submitting the claim.

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.

PPO

PPO (Preferred Provider Organization) plans allow members to visit any healthcare provider without a referral. In-network providers cost less, but out-of-network care is still covered at a reduced rate. When billing for a PPO plan, submit claims directly to the payer listed above. No referral documentation is needed.