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Contact Us. For more information about Facility Bulletins, contact Highmark Blue Shield Facility Customer Service at 1-866-803-3708. Last updated on 9/13/2017 10:31:01 AM.Provider Network. The SNP provider network is a network of health care providers who are contracted to provide health care services to SNP beneficiaries. SNPs must ensure that their MOC identifies, fully describes, and implements the following elements for their SNP provider networks. This MOC section contains 4 elements: Specialized Expertise.The full fee schedule is available on the Provider Resource Center. Access by signing into Availity > Payer Spaces > Highmark > Provider Resource Center. Attachment size currently allows for a total 45MB for 1 – 10 attachments. Allow for attachment total size of 100MB for 1 – 10 attachments.Annual Update to Highmark’s Professional Fee Schedule & Pricing Methodology. 5/14/2024.Office of Inspector General (OIG) Reporting Issues. Call Highmark Wholecare Hot Line (calls may be anonymous): (412) 255-4340 or 1-844-718-6400. Write. Highmark Wholecare. Attn: Medicare Compliance Officer. PO Box 535191. Pittsburgh, PA 15253-5191. Last updated on 1/12/2024 9:29:14 AM.Provider data changes can be made by visiting the provider portal or by using the Provider Information Management Forms section of the Provider Resource Center. After you submit your form successfully, Highmark will retain an electronic copy of your CAQH ProView profile in its database and will send you a confirmation email.Provider News. Provider News is a valuable resource for health care providers who participate in our networks. Published monthly on the last Monday of the month, Provider News conveys important product, policy, and administrative information, including billing, claims, and program updates. The publication also features the latest news ...Behavioral Health Fax Number for Authorization Requests: 1-877-650-6112. For precertification or continued stay review requests for Behavioral Health treatment, please submit relevant clinical information via fax to 1-877-650-6112. Submission of the complete medical record may slow down the process and is not an efficient way to …The full fee schedule is available on the Provider Resource Center. Access by signing into Availity > Payer Spaces > Highmark > Provider Resource Center. Attachment size currently allows for a total 45MB for 1 – 10 attachments. Allow for attachment total size of 100MB for 1 – 10 attachments.Availity Essentials: Introduction for Highmark Providers. Applications covered: General Navigation, Eligibility and Benefits Inquiry, Manage My Organization, Payer Spaces, and Authorizations. ... As more information becomes available about the status of Risk Manager, we will share that with you via the Provider Resource Center and Availity portal.Find a plan that fits your business needs. Talk to your client manager today and we'll help you find the right health plan for your company. GET STARTED. *Up to 14% lower total cost of care: Versus national insurers. Validated by an independent third party.Advanced Practice Provider (APP) Enumeration Form - Use this form to enroll NPs, PA-Cs, CRNAs and RNFAs with your participating practice. Contract Upload Form - Please only use this form to send Highmark a contract. Other uploads will not be processed and not be returned. Name Verification Form - Please use this form if a practitioner's name on ...Find the telephone numbers for different provider services and inquiries from Highmark Blue Cross Blue Shield. You can also access online resources at highmarkbcbs.com or …The 2024 Preventive Health Guidelines are now available on the Provider Resource Center. Every year, Highmark and participating network physicians review and update the Preventive Health Guidelines, which are made available to the practitioner community as a reference tool to encourage and assist you in planning your patients’ care.Short-Acting Opioid Prior Authorization Form. Specialty Drug Request Form. Sunosi Prior Authorization Form. Testosterone Product Prior Authorization Form. Transplant Rejection Prophylaxis Medications. Vyleesi Prior Authorization Form. Weight Loss Medications Request Form. Last updated on 1/23/2024 5:32:02 PM. Contact Us.Provider data changes can be made by visiting the provider portal or by using the Provider Information Management Forms section of the Provider Resource Center. After you submit your form successfully, Highmark will retain an electronic copy of your CAQH ProView profile in its database and will send you a confirmation email.For Help. For Availity Client Services assistance, call. 1-800-AVAILITY (282-4548) or, within the Availity portal, click Help & Training and then click on Availity Support. We also have a special section on the Provider Resource Center that includes additional background information and Frequently Asked Questions.See full list on hbs.highmarkprc.comIntroducing a new provider resource experience that simplifies getting you the information you need, when you need it. You're invited to visit an early release of our new site; try it out at providers.highmark.com.Your feedback is appreciated as we work to complete the experience.Provider Resource Center. Please access the Gateway Health Provider Portal via Navinet to determine if a drug/HCPCS code requires authorization and to submit authorization requests. View drug authorization requirements/submit authorization requests here: https://navinet.navimedix.com. Name.

Highmark is on a journey to transform health. This goal requires a focused partnership with our provider partners, and enhanced coordination with hospitals and post-acute care facilities to improve the care for our members. In an ongoing effort to strengthen this collaboration, we are developing a series of modules aimed at continuous ...Please provide the physician address as it is required for physician notification. 4. Fax the completed form and all clinical documentation to 1-866-240-8123 Or mail the form to: Clinical Services, 120 Fifth Avenue, MC PAPHM-043B, Pittsburgh, PA 15222.Quick Claims Functionality in Availity Now Available for Highmark Providers. 4/17/2024.Call Provider Services at 1-844-325-6251, Monday through Friday, 8 a.m. – 5 p.m., or contact your Provider Account Liaison. We work with a top network of doctors and Medicaid providers to provide high-quality, accessible health services to our members.The Medical Policy Department, in collaboration with physician specialists, develop and maintain medical necessity and coverage guidelines for all medical-surgical products for the Commercial and Medicare Advantage lines of business. These guidelines address medical services, including diagnostic and therapeutic procedures, injectable drugs ...

chevron_left training-and-resources print PRINT Print share SHARE Share with social media. Share ... Provider Service Center. Can't find an answer? Call us: 8 a.m. to 5 p.m. EST, Monday through Friday. ... All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or ...Attention CHIP Providers:CHIP Resources Available On the Provider Resource Center. We've added the following resources to the Provider Resource Center for providers who participate in the Pennsylvania Children's Health Insurance Program (CHIP). Highmark CHIP Gap Report: a monthly report Highmark will produce beginning March 2020. The report.…

Reader Q&A - also see RECOMMENDED ARTICLES & FAQs. Follow this link to access the CAQH. ( Previo. Possible cause: Behavioral Health: 833-581-1866. Gastric Surgery: 833-619-5745. Durable.