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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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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.