Plan Central Library - Archive 2014

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NEWS FOR ALL PROVIDERS

 

Date Posted Message
12/30/14 Attention Ordering And Performing Radiation Therapy Providers: Highmark Introduces Provider Pathways Program For Qualifying Providers
12/22/14 Ensure The Taxonomy Codes Linked To Your NPI Are Correct
12/22/14 Reminder: Change in Freedom Blue PPO Structure, New NAIC Number Coming
12/18/14 New Screen Options On Heathway's Rapid Response System (RRS) Introduced January 3, 2015
12/17/14 Attention Physical Medicine Providers: Letters Mailing This Week To Provider Pathways Qualifying Performers
12/17/14 Prior Authorization For Entyvio, Lupantea Pack, Plegridy, Ruconest, Sylvant, Vimizim
12/15/14 Update: Radiation Therapy G-Codes Replacing CPT Codes On Jan. 1, 2015
12/12/14 Highmark Navinet System Downtime Scheduled For Dec. 12-15
12/05/14 ICD-10 Clinical Coding Testing Available To All Network Providers
12/01/14 Reminder To Rehabilitative And Habilitative Therapy Services Providers: Sz Modifier To Be Implemented 1/1/15
11/26/14 Issue With Recent Authorization Requests - Highmark Is Aware Of And Has Corrected The Problem
11/19/14 Have Questions About Highmark's Medical Policies?
11/18/14 Reminder: Remaining 2014 and January 2015 Highmark Holiday Schedule
11/12/14 Attention Prescribing Physicians: Important Pharmacy/Formulary News
11/10/14 Highmark Strongly Supports State's Decision Not To Appeal Court Ruling On Community Blue Medicare HMO
11/06/14 Update: Highmark Urges Health Care Professionals To Be Prepared To Detect and Treat Ebola Patients
11/05/14 Attention Physical Medicine Providers: Highmark Introduces Provider Pathways Program For Qualifying Performers
11/03/14 Reminder: Care Registration Resets For The Physical Medicine Management Program Every Calendar Year
10/31/14 Highmark's Enhanced e-Subscribe Service Offers More Options
10/30/14 Update Regarding 11/3/14 Authorization Requirement For Code J0897 (Xgeva And Prolia)
10/22/14 Update: Highmark Urges Health Care Professionals To Be Prepared To Detect and Treat Ebola Patients
10/22/14 Attention UPMC Providers and Physicians with Only UPMC Privileges:
See Highmark 2015 page on Resource Center for Important Information about Network Changes
10/21/14 Update: Highmark Urges Health Care Professionals To Be Prepared To Detect Ebola In Children And Adults
10/20/14 Breast Pumps Covered By Insurance Can Now Be Ordered Directly From Manufacturer
10/16/14 Highmark Urges Health Care Professionals To Be Prepared To Detect A Potentially Infectious Ebola Patient
10/16/14 New Formulary Details: Medicare Advantage Annual Notice Of Changes Mailed To Members
10/14/14 Highmark NaviNet System Downtime Scheduled for Oct. 17-18
10/08/14 NEW DETAILS: Medicare Advantage Annual Notice of Changes Mailed to Members
10/06/14 An Open Letter to the People of Western Pennsylvania: Putting people first is Highmark Health’s pledge to you and your family
10/02/14 Consumer Spending Account Change To EOB, EOP, Remittance And 835 (Electronic Remittance Advice) Beginning Oct. 20, 2014
10/01/14 Prior Authorization For Hospice Patients’ Medicare Part D Prescription Drug Coverage
10/01/14 Change In Freedom Blue PPO Structure, New NAIC Number Coming
10/01/14 Billing Disputes Made Under Terms Of The Provider's Contract With Highmark
09/24/14 Medicare Advantage: Annual Mailing Released to Members
09/19/14 New Alpha Prefixes To Be Assigned To Blue Cross Blue Shield Of Michigan Members
09/12/14 Are You Looking For Ways To Improve Patient Care And Increase Revenue?
09/11/14 Highmark Supports Healthy PA, But Will Not Move Forward With PCO Product
09/09/14 Simponi And Simponi Aria Will Require Prior Authorization Through Walgreens Specialty Pharmacy, Effective 9/15/14
09/03/14 Prior Authorization Will Be Required For 10 Drugs, Effective 11/3/14
08/26/14 Navinet’s® Invaluable Search Functionality Saves Time And Streamlines Your Daily Workload
08/21/14 2014 Systems Survey: Winners Announced
08/21/14 ICD-10 Update: U. S. Department of Health and Human Services (HHS) Final Rule Released
08/18/14 Prior Authorization Requirement for Aloxi and Neulasta Delayed Until 11/3/14
08/01/14 Update: Behavioral Health Automated Care Management Submission Manual Available
08/01/14 Transitioning Authorization Requests For Post-Acute Care Admissions
07/31/14 IOP/PHP Outpatient Behavioral Health Program Providers: Authorization Requirement Postponed Until 9/2/14
07/22/14 Behavioral Health Automated Care Management Submission Manual Available
07/22/14 Rehabilitative and Habilitative Therapy Services Providers: SZ Modifier to be Implemented 1/1/15
07/21/14 Learn More About Post-Acute Care Management For Medicare Advantage Members; Dedicated Page Available
07/16/14 Reminder: Always Verify Member Identification Number
07/10/14 Downtime Scheduled For Highmark’S Navinet System – July 11-14
07/02/14 Reminder: Manual Payment Process
06/30/14 Attn: Hematologists And Oncologists: Prior Authorization To Be Required For Aloxi, Camptosar, Gemzar And Neulasta, Effective Sept. 1, 2014
06/30/14 Attention - Home Health Agencies And Skilled Nursing Facilities: Requirement To Report Health Insurance Prospective Payment System (HIPPS) Codes On Medicare Advantage Claims
06/27/14 Patients First Initiative Delivers Certainty For Western Pa. Health Care Consumers
06/25/14 Upload A Photo To Your Provider File And You Could Win $50 Gift Card
05/31/14 Highmark Delays Implementation Of Monitored Anesthesia Care Policy
05/23/14 Clarification Regarding Non-Coverage Determinations For Medicare Advantage Members
05/21/14 Highmark Health Names David Holmberg New President And Chief Executive Officer
05/20/14 Highmark, NaviHealth Partner To Enhance Post-Acute Care For Medicare Advantage Members
05/07/14 Allegheny County Schools Consortium To Stay With Highmark Exclusively Through 2018
05/06/14 When Was The Last Time You Verified Your Provider Data?
04/30/14 Physicians And Hospice Providers: New Process For The Coverage Of Prescription Drugs For Hospice Patients, Effective 5/1/14
04/28/14 Highmark Moving Ahead To Ensure ICD-10 Preparedness, Despite Federal Decision
04/25/14 Enhancement To The Navinet Claim Investigation Process To Improve Provider Satisfaction
04/16/14 REMINDER: Determining if Outpatient Services Require Authorization for PPO Blue and EPO Blue Members
04/11/14 Highmark NaviNet System Downtime Scheduled for April 11-14
04/08/14 'What's Up Wednesday' ICD-10 Teleconference Scheduled For April 16, 2014
03/19/14 New Resource Available to Support Your Transition to ICD-10
03/17/14 Radiation Therapy Authorization Program Information Updated
03/13/14 Highmark Navinet System Downtime Scheduled For March 14-15
03/10/14 'What's Up Wednesday' ICD-10 Teleconference Scheduled For March 19, 2014
02/27/14 Health Care Reform News: Enhanced Premium Delinquency Grace Period
02/24/14 Let Us Enroll New Group Practitioners In Your Group E-Subscribe Account
02/21/14 How The Deductible Works For PPO Blue Members With The High Deductible Health Plan (HDHP)
02/18/14 WEDI Offers Free ICD-10 Webinar Series
02/14/14 Update: Decision Reversed Regarding Esrd-Related Prescription Authorization
02/13/14 Provider Service Experiencing High Call Volumes Today
02/11/14 Highmark Retaining Members, Attracting New Enrollees Via Health Care Exchanges
02/11/14 'What's Up Wednesday' ICD-10 Teleconference Scheduled For Feb 19, 2014
02/05/14 Provider Service Experiencing High Call Volumes Today
02/05/14 Highmark Navinet Downtime Scheduled For Feb. 7–8
02/03/14 Provider Service Experiencing High Call Volumes Today
01/24/14 Bluecard News! Electronic Provider Access (EPA)
01/22/14 Attention Centre County Providers: Effective Jan. 1, 2014, Some Penn State Employees Will Begin Using HSAs To Pay For Eligible Medical Expenses
01/17/14 A Message Regarding Highmark's "Exchange" Products For 2014
01/17/14 Attn: Physicians Who Treat Dialysis Patients -- Authorization Required For ESRD-Related Prescription Drugs For Medicare Members
01/13/14 Internet Explorer 11 May Be Causing Technical Issues When You Request Physical Medicine Authorizations, View Eobs Via Highmark's Navinet® Site
01/09/14 Update: EFT Payments Issued From Dec. 14 Through Dec. 18, 2013
01/07/14 Attention Physicial Medicine Providers: Administrative Guide Revision Now Available
01/02/14 'What's Up Wednesday' ICD-10 Teleconference Scheduled For January 15, 2014

NEWS FOR PROFESSIONAL PROVIDERS

Date Posted Message
12/29/14 Eliminate Needless Authorization Requests That Can Cause Claims Processing Delays
12/26/14 Viekira Pak Must Be Obtained From Walgreens Specialty Pharmacy, Effective 12/19/14
12/23/14 Save Time, Energy By Making Sure A Service Or Medication Actually Needs An Authorization
12/16/14 Sleep Study Update For Ordering Physicians Out-Of-Center (Home) Based Sleep Studies Eligible Option For Commercial Members
12/03/14 Security Blue HMO And Freedom Blue PPO Members Have Full In-Network Access To UPMC Physicians
12/02/14 Highmark Suspends UPMC Physician Terminations
11/26/14 Prior Authorization No Longer Needed For Intravitreal Avastin
11/24/14 Radiation Therapy G-Codes Replacing CPT Codes On Jan. 1, 2015
11/13/14 Ordering Physicians: Three Ancillary Providers Will No Longer Participate In Highmark's Networks As Of 1/1/15
11/07/14 A Brand-New Issue Of Provider News Is Online! Includes Important Information About Changes Occurring In 2015
10/31/14 Low-Dose CT for Lung Cancer Screening to be Added to Radiology Management Program, Effective 1/1/15
10/30/14 Introducing Medical Policy Update
10/30/14 Select Medicare Advantage Members Eligible For New Diabetes Management Program
10/28/14 Correction To Procedure Code 90658 Allowance
10/17/14 New Hepatitis C Treatment Drug, Harvoni, Added To Self-Administered Injectable/Oral Biotechnology Drugs Program, Eff. 10/21/14
10/08/14 Walgreens Specialty Pharmacy Will Be Designated Provider For Certain Hit Drugs
10/08/14 Six Drugs Being Added To Self-Administered Injectable Or Oral Biotechnology Drugs Program
10/07/14 Oct. 17, 2014, Deadline Approaching: Keep Assignment Account Data Current To Avoid Claim Rejections
10/06/14 Giant Eagle Specialty Pharmacy Is Now Preferred Provider Of Transplant And HIV Treatment Drugs
10/01/14 12 Drugs Being Added To Highmark’S Medical Injectable Drug Program
09/19/14 Important Notice About Lipid Testing Claims
09/17/14 Oct. 17, 2014, Deadline Approaching: Keep Assignment Account Data Current To Avoid Claim Rejections
09/09/14 New Office Orientation Webinar Wednesday, September 17, 2014
08/14/14 Clarification: Medicare Advantage Benefit For Spinal Manipulation
08/08/14 Adjustments To UCR, Premier Blue Shield and Western Region Managed Care Reimbursement
08/06/14 NEW: Provider Initiative for Stars Measures - Use of High-Risk Medications and Diabetes Treatment for High Blood Pressure
08/04/14 Post-Acute Care Management For Medicare Advantage Members Begins Aug. 1, 2014
08/01/14 Attention Ophthalmologists: Update on Avastin
08/01/14 Physical Medicine Management Program (PMMP) Webinar Offered
07/28/14 Dietitian Webinar Now Available To View At Any Time
07/23/14 Important: Keep Assignment Account Data Current To Avoid Claim Rejections
07/15/14 Attention PCPs And Specialists: Medicare Advantage Provider Office Medical Record Reviews Began In June
07/08/14 Dietitians – Attend Our July 16 Webinar To Learn What Being A Highmark Credentialed Provider Means
07/07/14 Register Today For An Important Webinar On Highmark's House Call Program For Medicare Advantage Members
07/07/14 Effective 9/1/14, Highmark To Adjust Fees For Independent Laboratory Services For Medicare Advantage Members
07/07/14 Effective 9/1/14, Highmark To Adjust Fees For Select DMEPOS Items
07/02/14 Reminder: Be Sure To Follow Appropriate Peer-To-Peer Or Appeals Processes Regarding Pharmacy Coverage Denials
07/01/14 Attn: DMEPOS PAP Quality Program Participants: New October 1 Deadline For Data Submission; Administrative Requirements Updated
06/30/14 New Behavioral Health Codes Effective July 1, 2014: Procedure Code 0370T And 0371T, Billable For Medicare Advantage Members
06/19/14 New Office Orientation Webinar Wednesday, June 25, 2014
06/11/14 Attn: IOP/PHP Outpatient Behavioral Health Program Providers -- Effective 8/1/14, Partial Hospitalization And Intensive Outpatient Psychiatric Services Will Require Authorization
06/10/14 Highmark To Adopt CMS Multiple Procedure Payment Guidelines For Select Imaging Services, Effective 7/28/14
06/02/14 Complete a Brief 2014 Systems Survey By June 8th For Chance To Win Up to $500
05/20/14 Attn: Hematologists and Oncologists: Follow-up Regarding Authorization Process for Chemotherapy Drugs
05/19/14 CMS Guidance: Keeping Detailed Records For Skilled Nursing, Inpatient Rehab, Home Health And Outpatient Therapy Patients
05/09/14 Home Health Assessments: Better Care For Your Medicare Advantage Patients From Matrix Medical Network
05/09/14 We’re Now Accepting Candidates For Our CPMC Advisory Subcommittees
05/02/14 Hematologists/Oncologists: Four Chemotherapy Drugs To Require Authorization, Effective July 1, 2014
04/30/14 Stars Measures - Use of High-Risk Medications
04/17/14 New Office Orientation Webinar Friday, April 25, 2014
04/04/14 Highmark Blue Shield Office Manual Update: Quality Blue Evolution To P4V Is Complete
04/01/14 1500 Claim Form: Highmark Now Only Accepts The 02/12 Version
04/01/14 PCPs: Today’S The Day! The Quality Blue Evolution To P4V Is Complete
03/24/14 Two Drugs To Be Added To Prior Authorization Program And Retail Exclusivity Program, Effective 3/25/14
03/24/14 PCPs: There’s Only One Week Left Until The P4V Evolution Is Complete – Are You Prepared?
03/21/14 Report Release Rescheduled
03/17/14 PCPs: Only 2 Weeks Left Until the P4V Evolution is Complete!
03/17/14 Report Release Rescheduled
03/14/14 Highmark Now Credentialing Dietitians for All Commercial Networks
03/11/14 New Office Orientation Webinar Wednesday, March 19, 2014
03/10/14 PCPs: The Quality Blue Evolution To P4V Is Almost Complete – Only 3 Weeks Left!
03/03/14 PCPs: The Quality Blue Evolution To P4V Is Almost Complete – Only 4 Weeks Left!
02/24/14 PCPs: Upcoming Webinars On Quality Blue Physician Pay-For-Value Program Transition – Mark Your Calendars!
02/19/14 Correction To December 2013 PRN Article About Reimbursement Changes To Drugs And Biologicals
02/17/14 ATTN: PCPs – Upcoming Webinars On Quality Blue Physician Pay-For-Value Program Transition
02/12/14 New Office Orientation Webinar Wednesday, Feb 19, 2014
02/10/14 Attention 1500 Filers: Be Sure To Use Correct Software Format When Completing New 02/12 1500 Claim Form
02/04/14 2014 Medicare Advantage Incentive Program – Webinars Have Been Scheduled!
01/14/14 Effective 3/17/14, Two Codes To Be Added To Highmark's Radiation Therapy Authorization Program
01/14/14 Update On Pay-For-Value For PCPs
01/10/14 Updated Claim Adjustment Group, Reason And Remark Codes For Claim Adjustment Requests - Frequency Type 7 And 8 Claims
01/10/14 New Office Orientation Webinar Wednesday, January 22, 2014
01/03/14 Attention Physicians: 1-Month Prescription Supply Now Considered Up To 31 Days Under Medicare Advantage Pharmacy Benefit

NEWS FOR FACILITY PROVIDERS

Date Posted Message
12/26/14 The Application Of Medicare Advantage Skilled Nursing Facility Copayments For Admissions That Span 2014 Through 2015
12/18/14 Arzerra And Vectibix To Require Prior Authorization Before Administration, Effective Feb. 23, 2015
12/10/14 Enhancements To Tools That Support Post-Acute Care Management
11/26/14 Highmark To Make Changes To Facility Outpatient Behavioral Health Fee Schedules
11/06/14 Low-Dose CT For Lung Cancer Screening To Be Added To The Radiology Management Program Effective January 1, 2015
10/30/14 Introducing Medical Policy Update: Your New Source For Medical Policy Information
10/24/14 Attn: Interim Claim Submitters - Validation Error Corrected
10/08/14 Reporting Corresponding Date For Occurrence Code 50 When naviHealth Has Assigned RUG Level
10/02/14 Post-Acute Care Management For Medicare Advantage Members Page Has Been Updated
09/15/14 Attn: Home Health Providers: September 16Th Erie Home Health Regional Update Session Has Been Cancelled
09/15/14 Post-Acute Care Management For Medicare Advantage Members Page Has Been Updated: Frequently Asked Questions And Contact Information Links Revised
09/15/14 ATTN: Home Health Providers - Register Now For The Western Region Home Health Regional Update Session
09/08/14 ATTN: Home Health Providers - Register Now For The Western Region Home Health Regional Update Sessions
09/04/14 Highmark Facility Manual Debuts In Delaware!
08/29/14 naviHealth Closed Monday, September 1, 2014 In Observance Of Labor Day Holiday
08/29/14 ATTN: Skilled Nursing Facilities: Reporting Assessment Indicators for Pennsylvania Medicare Advantage Members
08/27/14 ATTN: Skilled Nursing Facilities: Change in Assessment Reporting Process for Pennsylvania Medicare Advantage Members
08/12/14 Revision: Highmark's Third Quarter Updates For Outpatient Prospective Payment System (OPPS) Providers
08/05/14 Facility Alerts Debuts! Initial Announcement Of Upcoming Changes To The Highmark Facility Manual Issued
08/01/14 NOMNC Forms Revised Effective Aug. 1, 2014 with Updated QIO Contact Information
07/29/14 Reimbursement For Inpatient Hospice Services When The Member's Discharge Status Indicates Expired
07/11/14 Interqual 2014 Criteria To Be Implemented
07/01/14 Attention: Ambulatory Payment Classification Facilities: Reminder: Highmark's Third Quarter Updates For Outpatient Prospective Payment System (OPPS) Providers, Bill Type 014X And 013X
06/27/14 Learn About Future And Current Communication Vehicles: Online Training Now Available – Take 30 Minutes To View The Future Ease Of Facility Communications!
06/16/14 Register Now For Regional Educational Sessions With naviHealth - New Session Added!
06/05/14 Register Now For Regional Educational Sessions With Navihealth
05/20/14 Follow-Up Regarding Authorization Process For Chemotherapy Drugs
04/30/14 Highmark To Make Changes To The Outpatient Behavioral Health Fee Schedules: Fee Changes Effective May 1, 2014
03/19/14 Clarification on Bill Type 014X and 013X
01/16/14 Effective March 17, 2014, Two Procedure Codes To Be Added To Highmark's Radiation Therapy Authorization Program
01/10/14 Electronic Remittance Advice Update: APC Code Available at Line Level
01/06/14 Attention: Acute-Care Hospitals & Ambulatory Surgery Centers - Clinic Visit Billing: Procedure Code G0463
Last updated on 4/20/2021

 

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