Highmark Health Options Provider Manual

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2021 Provider Manual - Highmark® Health Options

(7 days ago) 2021 PROVIDER MANUAL 11 1.1 HIGHMARK HEALTH OPTIONS OVERVIEW Introduction The Highmark Health Options Provider Manual contains an integrated set of procedures and policies that apply to network participating provider offices. This manual was designed to be your primary reference guide to Highmark Health Options. General Highmark Information

https://www.highmarkhealthoptions.com/content/dam/digital-marketing/en/highmark/highmarkhealthoptions/providers/provider-resources/2021_06042021_Provider_Manual_VF.pdf

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highmark health options provider manual

(9 days ago) THE HIGHMARK HEALTH OPTIONS PROVIDER MANUAL 5 P a g e 2019 UNIT 1: HIGHMARK HEALTH OPTIONS OVERVIEW, Continued Chapter/Unit TOPIC See Page 4.3 Policies and Procedures for Providers • M aint g ed cl and F nan Re ords 112 Med ic al Re or ds n tenance an en Upda ed! 112 F inan c al Reor ds M n tenance an en on 124

https://www.highmarkhealthoptions.com/content/dam/digital-marketing/en/highmark/highmarkhealthoptions/providers/provider-resources/Medicaid_provider_manual.pdf

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Health Options Provider Manual - Provider Resource Center

(4 days ago) Health Options Provider Manual. Health Options is a Highmark Blue Cross Blue Shield Delaware owned and administered managed care organization contracted with the State of Delaware's Department of Health and Social Services (DHSS), Division of Medicaid and Medical Assistance (DMMA), to provide health services to Medicaid-eligible individuals.

https://hdebcbs.highmarkprc.com/Education-Manuals/The-Health-Options-Provider-Manual

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Provider Manual and Resources - Highmark Health Options

(1 days ago) Provider resources for Highmark Health Options include: external resources, provider manual, provider contracts and procedure codes.

https://www.highmarkhealthoptions.com/providers/provider-resources.html

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Highmark Provider Manual - Provider Resource Center

(Just Now) 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.

https://hbs.highmarkprc.com/Education-Manuals/Highmark-Provider-Manual

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THE HEALTH OPTIONS PROVIDER MANUAL - Enitre Manual

(6 days ago) The Health Options Provider Manual contains an integrated set of procedures and policies that apply to network participating provider offices. information . Health Options is a Highmark Blue Cross Blue Shield Delaware (“Highmark Delaware”) owned and administered managed care organization contracted with the State of Delaware’s

https://content.highmarkprc.com/Files/Region/hdebcbs/EducationManuals/HOPM/hopm-entiremanual.pdf

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Providers - Highmark® Health Options

(2 days ago) Highmark Health Options has a vast network of providers to offer the best-in-class healthcare programs to Delaware Medicaid and Delaware Healthy Children Program (DHCP) members and Long-Term Care (DSHP Plus) members. We work with a top network of doctors and providers to provide high-quality, accessible health services to our members.

https://www.highmarkhealthoptions.com/providers.html

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Highmark Health Options

(8 days ago) Look to Highmark Health Options for Medicaid coverage and managed care. Even when you’re not sick, we’ll help with your wellness goals and life goals. Choose coverage that goes beyond the basics so you can live your best life. Enroll today by calling the Delaware Health Benefits Manager at 1-800-996-9969.

https://www.highmarkhealthoptions.com/

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Provider Communications Highmark Health Options

(6 days ago) Provider Updates and Notices. picture_as_pdf LTSS Service Authorizations Extension. picture_as_pdf Billing Change for DME NOC and Miscellaneous Codes. picture_as_pdf Shared Health Migrated to Highmark Health Options Support Center. picture_as_pdf Pharmacy and Durable Medical Equipment (DME) Guidelines (Updated Nov. …

https://www.highmarkhealthoptions.com/providers/provider-communications.html

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Provider Forms Delaware Highmark Health Options

(2 days ago) Call Provider Services at 1-844-325-6251, Monday through Friday, 8 a.m. to 5 p.m. 800 Delaware Avenue, Wilmington, DE 19801 Highmark Health Options is an independent licensee of the Blue Cross Blue Shield Association, an association of independent Blue Cross Blue Shield Plans.

https://www.highmarkhealthoptions.com/providers/provider-resources/provider-forms/

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CHAPTER 6: BILLING AND PAYMENT

(2 days ago) Highmark Provider Manual, Reimbursement Policy, provider newsletters, Special Bulletins, and other communications (e.g., Plan Central Messages) should be referenced for the most up-to-date information. Billing professional services Highmark requires hospitals to bill all services performed by physicians and

https://content.highmarkprc.com/Files/EducationManuals/ProviderManual/hpm-chapter6-unit3.pdf

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CHAPTER 6: BILLING AND PAYMENT

(2 days ago) 5 HIGHMARK PROVIDER MANUAL Chapter 6.1 Page. Billing & Payment: General Claim Submission Guidelines . 6.1 TIMELY FILING REQUIREMENTS, Continued . Highmark as secondary payer . When Highmark is a secondary payer, a provider must submit a claim within the timely filing time frames indicated aboveand attach an EOB to the claim that

https://content.highmarkprc.com/Files/EducationManuals/ProviderManual/hpm-chapter6-unit1.pdf

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Provider Resource Center

(8 days ago) Provider Directory. Site Map. Legal Information. 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.

https://hbs.highmarkprc.com/

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Provider Manual - Highmark Blue Cross Blue Shield West

(8 days ago) see Section 7.6 of this Provider Manual. Highmark Health Insurance Company P O Box 7004 Wheeling, WV 26003 Please submit Medicare Advantage PPO Claims to the above address for processing including other states Medicare Advantage PPO plans who participate in reciprocal network sharing. 7.3 Claim Forms / Coding / Modifiers 7.3.1 Forms

https://www.highmarkbcbswv.com/PDFFiles/Provider-Manual-Chapter-07-2011-07.pdf

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CHAPTER 6: BILLING AND PAYMENT

(2 days ago) *When the billing or rendering provider’s NPI is associated with more than one Highmark -contracted specialty, the Provider Taxonomy Code correlating to the contracted specialty must be submitted in addition to the NPI. This enables the accurate application of the provider ’s contractual business arrangements with Highmark.

https://content.highmarkprc.com/Files/EducationManuals/ProviderManual/hpm-chapter6-unit4.pdf

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CHAPTER 3: PROVIDER NETWORK PARTICIPATION

(2 days ago) 2 HIGHMARK PROVIDER MANUAL Chapter 3.1 Page Provider Network Participation: Network Participation Overview 3.1 INTRODUCTION TO NETWORK PARTICIPATION Overview Highmark pays claims for services performed by licensed, eligible health care providers. Eligible providers may sign an agreement to participate in one or more

https://content.highmarkprc.com/Files/EducationManuals/ProviderManual/hpm-chapter3-unit1.pdf

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Highmark Provider Manual - Contact Information for

(8 days ago) 1 HIGHMARK PROVIDER MANUAL Chapter 1.2 Page. Delaware Contact Information . HIGHMARK CONTACT INFORMATION FOR DELAWARE PROVIDERS . PROVIDER SERVICE CENTER . Please use NaviNet® for all of your routine eligibility, benefit, and claim inquiries. NaviNet is also the preferred method for authorization requests.

https://content.highmarkprc.com/Files/EducationManuals/ProviderManual/TipSheets/hpm-c1u2-de-contact-info.pdf

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CHAPTER 3: PROVIDER NETWORK PARTICIPATION

(2 days ago) 6 HIGHMARK PROVIDER MANUAL Chapter 3.2 Page. Provider Network Participation: Professional Provider Credentialing . 3.2 HIGHMARK NETWORK CREDENTIALING POLICY . Overview . Physicians and any applicable allied health professionals must be credentialed by Highmark to participate in the Premier Blue Shield, Western Region managed

https://content.highmarkprc.com/Files/EducationManuals/ProviderManual/hpm-chapter3-unit2.pdf

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Provider Resource Center

(1 days ago) Provider News is the bimonthly informational newsletter Highmark publishes for health care professional & facilities (and office staff) located in Central Pennsylvania and the Lehigh Valley, Northeastern Pennsylvania and Southeastern Pennsylvania, who participate in our networks and submit claims to Highmark using the 837P/837I HIPAA transaction or the CMS 1500 or UB form.

https://hbs.highmarkprc.com/Newsletters-Notices/Provider-News

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Provider Resource Center

(6 days ago) Highmark Delaware utilizes the radiology management services of NIA Magellan for non-emergent, high-tech outpatient radiology services rendered to members enrolled in Highmark Delaware health plans. NIA is NCQA and URAC accredited and offers our participating providers a program that supports standard protocols and offers the expertise of peer

https://hdebcbs.highmarkprc.com/Care-Management-Programs/Program-Information

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Highmark Provider Manual - hnenybs.highmarkprc.com

(4 days ago) 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.

https://hnenybs.highmarkprc.com/Education-Manuals/Highmark-Provider-Manual

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Provider Resource Center

(7 days ago) Legal Information. 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.

https://hdebcbsnn.highmarkprc.com/Claims-Payment-Reimbursement/Fee-Schedule-Information

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Provider Resource Center

(9 days ago) To help ensure that outpatient physical medicine services (physical therapy, occupational therapy and manipulation services) provided to our members are consistent with nationally recognized clinical guidelines, Highmark has contracted with WholeHealth Networks, Inc. (WHN), a subsidiary of Tivity Health Support, LLC., to administer a registration process …

https://hbs.highmarkprc.com/Care-Management-Programs/Physical-Medicine-Management-Program

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Provider Resource Center

(Just Now) Effective January 1, 2020, Highmark is creating a new network of home health agencies to align with the commitment to work with healthcare providers to make sure that our members receive high-quality health care that is affordable.

https://hbs.highmarkprc.com/High-Performance-Networks/High-Performance-Home-Health-Network

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Provider Resource Center

(4 days ago) Educational Resources - Member and Provider. Health Options Provider Manual. Highmark Provider Manual. Inventory Request Form. Population Health University. Practice Site Resources. Preventive Health Guidelines. Provider Data Accuracy Compliance. Provider File Management: NaviNet Guide.

https://hdebcbs.highmarkprc.com/Claims-Payment-Reimbursement/Medical-Policy-Interior

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Your Health Care Partner Highmark

(5 days ago) Penn State Health and Highmark Health join forces to create a high-value, community-based health care network for members and patients Highmark Inc. signs outcomes-based agreement with AstraZeneca for Symbicort Highmark launches programs to assist seniors Expecting moms can "Meet Dr. Right" at Jefferson Hospital Sept. 12

https://www.highmark.com/

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Behavioral Health Forms - Provider Resource Center

(1 days ago) 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.

https://hdebcbs.highmarkprc.com/Forms/Behavioral-Health-Forms

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Behavioral Health Toolkit - Self-Care For Providers

(5 days ago) 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.

https://hbs.highmarkprc.com/Education-Manuals/Behavioral-Health-Toolkit-Self-Care-For-Providers

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Provider Resource Center

(8 days ago) 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.

https://hdebcbsnn.highmarkprc.com/Claims-Payment-Reimbursement/DE-Medicaid-Fee-Schedules

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Behavioral Health Forms - Provider Resource Center

(9 days ago) This page contains Behavioral Health forms for providers to use when communicating with Highmark. Fax consent form and treatment plan to 1-888-663-0261. Residential Treatment Center (RTC) must be accredited by a nationally recognized organization and licensed by the state, district, or territory to provide residential treatment for medical

https://hbcbs.highmarkprc.com/Forms/Behavioral-Health-Forms

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Contact Us Highmark - Your Health Care Partner Highmark

(7 days ago) Diverse offering of virtual health options increases access for Highmark members Highmark sponsors “Meet Dr. Right” event at Forbes Hospital March 29 Do not use this mailing address or form for provider inquiries. Providers in need of assistance should contact provider services at 800-241-5704 (toll-free).

https://www.highmark.com/contact.html

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