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Plan Central Library - Archive 2013

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NEWS FOR ALL PROVIDERS

 

Date Posted Message
12/27/13 Notice Regarding Spending Account Claims And EFT Payments Issued From Dec. 14 Through Dec. 18, 2013
12/23/13 2013 Holiday Schedule
12/19/13 Manual Payment Process Updated
12/17/13 Are You Experiencing Difficulty With The EOB And Remittance Inquiry? Read This Navinet Tip Sheet For Helpful Instructions.
12/16/13 Online Payment Information Delayed; Payments Not Impacted
12/12/13 Highmark Navinet System Downtime Scheduled For Dec. 13-14; Simplified Sleep Study Authorization Function To Launch For Professional Providers
12/11/13 Cancellation – Dec.18, 2013, ‘What’S Up Wednesday’ ICD-10 Teleconference
12/09/13 Effective Immediately: Allow 30 Calendar Days Before Submitting Bluecard Secondary Claims
12/05/13 'What's Up Wednesday' ICD-10 Teleconference Scheduled for Dec. 18, 2013
11/21/13 Highmark's Medical Management & Policy (MM&P) Holiday Schedule
11/12/13 Medicare Advantage Special Needs Plan Provider Training Now Available
11/08/13 Reminder: Remaining 2013 And January 2014 Holidays
11/05/13 'What's Up Wednesday' ICD-10 Teleconference Scheduled for Nov. 20, 2013
10/28/13 Government Budget Sequestration Update: Highmark Health Services To Adjust Payments Effective 1/1/14 Resulting From Medicare Spending Cuts
10/14/13 Enhancements to the EFT Attestation and Registration Pages
10/14/13 Visit And Bookmark Our New Health Care Reform Site, Specifically For Providers!
10/07/13 Update To Recent Highmark Health Services Navinet Enhancements
10/07/13 Highmark Health Services Downtime Scheduled for October 11-12, 2013
09/30/13 Important: Keep Assignment Account Data Current To Avoid Claim Rejections
09/20/13 Update On Simplified Copay And Visit Information For PT, OT, Speech Therapy And Spinal Manipulation Services
09/19/13 Navinet For Highmark Blue Cross Blue Shield Downtime Scheduled For Sept. 20-21
09/13/13 Navinet Downtime Scheduled For Sept. 13-14
09/13/13 Now Available On Navinet: Simplified Copay And Visit Information For PT, OT, Speech Therapy And Spinal Manipulation
09/09/13 What's Up Wednesday ICD-10 Teleconference Scheduled for Sept. 18, 2013
09/06/13 Update On Simplified Copays And Visit Counts For PT, OT, Speech Therapy And Spinal Manipulation Therapy Services
08/30/13 Note To Physicians And Home Health Agencies: Reminder: Two Private Duty Nursing Procedure Codes Will Require Authorization Effective September 2, 2013
08/30/13 Simplified Copayments And Visit Counts For Physical Therapy, Occupational Therapy, Speech Therapy And Spinal Manipulation Services, Effective With Dates Of Service 9/1/2013 And Beyond
08/30/13 Important Changes Effective October 11, 2013: Electronic Remittance Advice (ERA) And Electronic Funds Transfer (EFT) Enrollment
08/19/13 How to Participate in 'What's Up Wednesday' Teleconference
08/15/13 ICD-10 Library Page Now Available In The Provider Resource Center
08/14/13 Resolution of Incorrect Claim Rejections from July 24 to Aug. 9
08/14/13 Prepare for ICD-10 with 'What's Up Wednesday'
08/02/13 Notice: Observation Care Reporting Guidelines For Codes (99218-99220 & 99224-99226)
08/02/13 Attention Behavioral Health Practitioners: Cost Sharing Claims Issues Have Been Resolved
07/26/13 Submitting Claims For Services That Are Statutorily Excluded By Medicare For Bluecard® Members
07/25/13 IBC Personal Choice PPO Claims Should Be Filed To Highmark, Effective Nov. 1, 2013
07/22/13 Introducing a New Provider Service Center Unit and Phone Option Available July 22, 2013
07/19/13 Notice Regarding Spending Account Claims and EFT Transactions Issued July 17, 2013
07/18/13 Highmark Limiting Number of Claims in Single 837 Transaction (ST-SE Envelope), Effective 7/13/13
07/17/13 REMINDER: Adding Trusted Sites to Internet Explorer
07/10/13 NaviNet Downtime Scheduled for July 12-13
06/25/13 Attention Physical Medicine Providers: Use of Patient-Specific Functional Scale (PSFS) Expanded Beginning July 1, 2013
05/30/13 Reminder: Full Implementation Of Physical Medicine Management Program Begins 6/1/13
05/15/13 Pediatric Critical Care Physicians: Reminder About Reporting Specific Services Included During Patient Transport
05/15/13 NaviNet Downtime Scheduled for May 17-18
05/02/13 Latest Edition of Behind the Shield Now Online -- Read This Issue Now!
04/26/13 Attention Physical Medicine Providers: Highmark Allowing Providers Until 5/31/13 To Complete Treatment Plans Initiated During Physical Medicine Management Program Soft Implementation Period
04/15/13 New Look For Our Plan Central Page
03/21/13 Highmark To Update Its List Of Outpatient Procedures-Services Requiring Authorization
02/12/13 Physical Medicine Management Program News

NEWS FOR PROFESSIONAL PROVIDERS

Date Posted Message
12/23/13 Attn: Doctors Of Chiropractic – Include CMS-Required Coding On Claims For Medicare Advantage Patients
12/23/13 Attn: Doctors Of Osteopathy – Choose Physical/Occupational Therapy Category For Auth Requests Through PMMP
12/20/13 Reminder For DMEPOS Providers Who Dispense Diabetic Supplies
12/17/13 BlueCard PPO Professional Host Network Change, Effective 1/1/14
12/13/13 Medication Request Denials Appeals Process To Follow New Progressive-Level Procedure For Highmark Commercial Members
12/03/13 Navinet Selection Form For Prescription Drug Authorizations Now Updated
11/13/13 Highmark's New Office Orientation Webinar Wednesday, November 20, 2013
11/08/13 Diabetic Supplies, Part B Drugs Now Available At Giant Eagle Pharmacy
11/04/13 Highmark To Update Its List Of Outpatient Procedures/Services Requiring Authorization
11/04/13 Six Procedure Codes To Be Added To Radiology Management Program, Effective Jan. 13, 2014
10/24/13 Update: Medicare Advantage Care Gap Webinar Sessions Will Be Extended
10/24/13 Attention Physical Therapists, Occupational Therapists And Speech Pathologists: New G-Codes, Severity Modifiers Required On Outpatient Therapy Claims For Medicare Advantage Patients
10/22/13 Reminder: IBC Personal Choice PPO Claims Should Be Submitted Via Bluecard®, Effective 11/1/13
10/21/13 Last Chance To Take Medicare Advantage Stars Training; Physicians Can Earn $100
10/17/13 Print Preview Function Now Available For Professional Claim Status Inquiry!
10/16/13 Important: (Updated) Keep Assignment Account Data Current To Avoid Claim Rejections
10/10/13 Register Today! Highmark Health Services New Office Orientation Webinar On Thursday, October 17, 2013
10/04/13 Timeline For New 02/12 1500 Claim Form – Highmark Blue Cross Blue Shield Will Accept On 2/10/14
10/02/13 Attn: Single-Practitioner Offices, Including Doctors Of Chiropractic: Important Information About New Temporary Process For Entering 1500 Claim Submission On Navinet
09/27/13 Attention Quality Blue Pay-for-Performance Participants: Significant Changes Coming April 1, 2014
09/11/13 Hemophilia Clotting Factors Criteria Revised Effective 10/28/2013
09/10/13 Highmark Health Services New Office Orientation Webinar Wednesday,September 18, 2013
08/29/13 Accepting Candidates For CPMC Advisory Subcommittees
08/23/13 Highmark Foundation Hosting Free Childhood Obesity Conference On 9/25/13
08/08/13 New Office Orientation Webinar - August 16, 2013
08/07/13 Correction: Recent Mailing Should Have Stated HCPCS Code 90283 for Bivigam
07/19/13 Quality Blue Participants: If You Received a Meaningful Use Submission Error, Click Here for Update
07/15/13 Ambulance Service Providers: Submitting Fractional vs. Whole Numbers for Mileage on Claims
07/12/13 New Office Orientation Webinar Tuesday, July 16, 2013
07/11/13 Quality Blue Participants: If You Receive A Meaningful Use Submission Error, Click Here
07/02/13 Two Private Duty Nursing Procedure Codes Will Require Authorization, Effective Sept. 2, 2013
07/01/13 New Office Orientation Webinar Monday, July 8, 2013
06/27/13 2013 Global Fee Updates
06/14/13 Reporting Guidelines for Procedure Codes 23130 and 23410
05/31/13 New Office Orientation Webinar to debut on Friday, June 7, 2013. Register Today!
05/17/13 News Regarding Procedure Codes 99487, 99488 & 99489
05/08/13 Quality Blue: Important News For PCP Practices
04/25/13 Attn: Quality Blue Participants -- News About Meaningful Use, Updates To G-Codes And HEDIS Indicators
04/23/13 Nerve Conduction Study Coding Update
04/01/13 Attention Psychiatrists -- Important News Regarding Deductibles and Coinsurance Associated with Visits that Combine Evaluation & Management and Psychotherapy
03/21/13 Attention PCPs -- Starting 05/01/13 Home Health Aide Services Will No Longer Be A Covered Benefit Under Highmark's AIS Program
03/29/13 Reminder to PCPs -- Verify Member Benefits Prior to Conducting Alcohol Screening and Brief Counseling
03/11/13 Attention Medical Imaging Providers -- Important Message Regarding Billing for HCPCS Code A9500
03/11/13 Highmark's Caring Program for Children Available for your Highmark-Enrolled Chip Patients

NEWS FOR FACILITY PROVIDERS

Date Posted Message
12/19/13 ATTN Home Health Agencies: Post-Acute Assessment Tool Added To Home Care/Hospice Authorization Menu
12/06/13 Attention Home Health Agencies: Requests For Private Duty Nursing For Calendar Year 2014 Will Be Accepted Beginning December 16, 2013
11/26/13 Outpatient Prospective Payment System (OPPS) Claims Issue Identified
11/11/13 Attention, Home Health Agencies And Skilled Nursing Facilities: Reporting Requirement For Health Insurance Prospective Payment System (HIPPS) Codes Delayed
10/31/13 Highmark Health Services To Make Changes To The Outpatient Behavioral Health Fee Schedules
10/23/13 Update On Reporting G-Codes And Severity/Complexity Modifiers For Medicare Advantage Members
10/23/13 Claims Issue Identified Impacting Some Acute-Care Hospital Outpatient Surgery Claims
10/16/13 Announcing the Highmark Health Services Facility Manual
10/01/13 Reminder: Specialist Virtual Visit Benefit Enhancement Effective Jan. 1, 2013
07/17/13 Change to the Highmark Outpatient Fee Schedule for Seven Surgical Procedure Codes, Effective Aug. 1, 2013
07/12/13 Interqual 2013 Criteria To Be Implemented
07/02/13 Note to Home Health Agencies: Two Private Duty Nursing Procedure Codes Will Require Authorization, Effective Sept. 2, 2013
04/01/13 Communication Changes Coming in 2013!
01/23/13 Attention Skilled Nursing Facilities -- Clarification of the Medicare Advantage Skilled Nursing Copayment when Admission Services Span from 2012 through 2013
01/17/13 Clarification of Reimbursement for New Procedure Code 37197
Last updated on 4/20/2021

 

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Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Highmark Western and Northeastern New York Inc., serves eight counties in Western New York under the trade name Highmark Blue Cross Blue Shield of Western New York and serves 13 counties in Northeastern New York under the trade name Highmark Blue Shield of Northeastern New York. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration.