Highmark Provider Services

Available resources for highmark providers Read CORRECTION. One Source For Information For All Providers.

ELECTRONYSTAGMOGRAPHY VIDEONYSTAGMOGRAPHY VNG SERVICES.

Highmark provider services. Introducing The Highmark Provider Manual. ACA and Commercial Members. As we are all adapting.

ELECTRONYSTAGMOGRAPHY VIDEONYSTAGMOGRAPHY VNG SERVICES. Working with health care providers and care teams Highmark is helping to implement nationally accepted evidence-based guidelines. Primary carespecialist communication Highmark network primary care physicians primary care CRNPs and specialists including medical surgical and behavioral health must communicate with one.

Professional Providers 1 -866731 8080. Specialists in Highmarks networks play an equally important role of providing specialty services to Highmark members. Welcome to the Highmark Provider Portal.

COVID-19 CORONAVIRUS INFORMATION. Comprehensive prescription drug coverage. More important theyre proven to add up to better patient outcomes and more affordable care.

It contains useful information and resources to give providers a comprehensive understanding of the programs offered to Highmark. The ordering provider is typically responsible for obtaining authorizations for the proceduresservices included on the List of ProceduresDME Requiring Authorization. Incident To services are also relevant to services performed by auxiliary personnel working within the scope of license nurses technicians and therapists and supervised by certain non-physician practitioners.

For medically necessary ambulance transport services provided to Highmark members payment is made in accordance with the members benefit plan and if applicable the providers contract if the required benefit is available and the claim is billed appropriately. Proceduresservices on Highmarks List of ProceduresDME Requiring Authorization see below Speech Therapy services including those provided to Medicare Advantage members. NaviNet gives users real-time access to Highmarks membership claims and provider and payment systems making your job easier.

Lab radiology provider access Luzerne Lackawanna counties only You can get services at your PCPs office. Defined as those services furnished by someone other than the supervising physician and billed under the physicians NPI. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania.

A large network of doctors hospitals and specialists including vision and dental service providers. Broad range of preventive health screenings and tests. Often these models only require some changes to the way most practitioners deliver care today.

Please listen carefully to the available options to reach the appropriate area for your inquiry. It is designed to assist in understanding the full range of programs and services available to Highmark members. NaviNet seamlessly integrates all insurer-provider transactions into one system such as inquiries on referralsauthorizations eligibility benefits claims status claims investigations codes and providerfacility searches.

The Highmark Member Clinical Programs and Services catalog is a reference guide for health care providers. Highmark member cost-sharing deductibles coinsurance and copayments for outpatient in-network Virtual Visits and covered Telemedicine Services provided by our approved national vendors American Well Doctor On Demand and Teladoc will be waived for dates of service from March 13 through June 30 2021 regardless of medical diagnosis. CENTRAL NORTHEASTERN REGIONS.

Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Available resources for highmark providers Read CORRECTION. Highmark Health Options Offers.

Strong care management solutions and responsive member service. Research contact Highmarks Provider Services for your service area as indicated below. Highmarks determination on which entity is to bill for ambulance transport.

Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Is a national diversified health care partner based in Pittsburgh that serves members across the United States through its businesses in health insurance dental insurance vision care and reinsurance. It is contracted to manage a network of dental providers for Highmark and Highmark Health Insurance Company.

To ensure our members are quickly able to access the right care in the right setting during the COVID-19 outbreak Highmark is committed to assisting you in this important effort to ensure that our members have continued access to quality health care despite such challenging circumstances.

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