Providers.highmark.com

Home [providers.highmark.com]

WEBHighmark's Provider Resource Center is your source for all provider-related information and updates. The PRC offers resources to assist in the treatment of your Highmark patients, …

Actived: 1 days ago

URL: https://providers.highmark.com/

Behavioral Health Resources

WEBHighmark strives to actively help providers identify members who can benefit from fully accessing their mental health/substance use disorder benefits in a timely …

Category: Health Go Health

Medical Policies

WEBFind comprehensive medical policy guidelines for all of Highmark’s medical-surgical products, including managed care.

Category: Medical Go Health

Claims and Authorization

WEBClaims & Authorization Understand Highmark's authorization requirements, get guidance on reimbursement policies and programs, and find helpful resources and tips.

Category: Health Go Health

Enhanced Community Care

WEBEnhanced Community Care Management (ECCM) is a non-billable service offered for members of certain Highmark plans. ECCM is designed to support the most …

Category: Health Go Health

Post-Acute Care Management For Medicare Advantage Members

WEBHighmark has initiated a partnership with naviHealth effective August 1, 2014. naviHealth is a leader in post-acute care management and care transitions for …

Category: Health Go Health

Behavioral Health Forms

WEBFor precertification or continued stay review requests for Behavioral Health treatment, please submit relevant clinical information via fax to 877-650-6112.

Category: Health Go Health

Pharmacy Prior Authorization Forms

WEBForms Authorization Forms Pharmacy Prior Authorization Forms Behavioral Health Forms

Category: Health Go Health

Obtaining Authorizations

WEBThe preferred – and fastest – method to submit preauthorization requests and receive approvals is the online provider portal. The online provider portal (Availity) is …

Category: Health Go Health

Free Market Health

WEBUpon an approved prior authorization for select specialty drugs, Free Market Health receives the patient referral for management. Note: if the authorization request is …

Category: Health Go Health

Highmark Provider Service Center Quick Reference Contact …

WEBWestern Region: Professional Providers 800-547-3627; Facilities 800-242-0514. Hours of Availability: 8 a.m. to 5 p.m. EST, Monday through Friday. Central & Northeastern …

Category: Health Go Health

WEIGHT LOSS MEDICATIONS FORM Fax to 1-866-240-8123

WEBNOTE: The prescribing physician (PCP or Specialist) should, in most cases, complete the form. Please provide the physician address as it is required for physician notification. …

Category: Health Go Health

Authorization Forms

WEBPharmacy Prior Authorization Forms. Find additional information and updates in Provider News: Provider News. Availity’s multi-payer platform will support the …

Category: Health Go Health

Authorization Guidance

WEBBefore you submit for prior authorization on Availity, we recommend that you consult Member Eligibility & Benefits. If you don’t have access to Availity, you can review other …

Category: Health Go Health