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Highmark provider phone number

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Your staff's knowledge and attitude far surpassed the others. Thank you for your excellence! The rep and supervisor went out of their way to get the issue resolved. It was nice to have a direct contact with the same representative until the problem was resolved. As always excellent, professional, knowledgeable customer service.

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A Happy Friday message from a Satisfied User! I just transmitted my first batch of electronic claims through Claim Shuttle! My question is, "Why didn't I find out about Claim Shuttle earlier?!? There simply is no comparison! Everything about it including your team is great! The ease of use and user-friendly environment is awesome. My work is truly cut in half by using Claim Shuttle. Please share my thanks with everyone involved.

I am so happy to have found you! I always get the most fabulous service when calling or emailing!!! Your customer support reps are the best!!! Have an offer code? Pennsylvania Blue Shield: Highmark. Section 7 If you have purchased our SolAce software information please call us for testing requirements.

Acceptance and Submission Section Please check the box to accept their terms Review your information and Submit Waiting for a Response Once the complete provider enrollment packet has been received, the documents will be processed.

ClaimShuttle Testimonials. Have never had any problems and this is the easiest claim site. However, when you make an appointment it ensures that the appropriate Highmark representative will be available at a time that is most convenient for you. For a personalized meeting with a Highmark Direct health insurance store associate, make an appointment at one of our convenient store locations.

We have 11 Highmark Direct health insurance stores conveniently located throughout Pennsylvania. Check our store locations to find a Highmark Direct health insurance store near you. Yes, you can visit your local Highmark Direct health insurance store anytime to pay your monthly insurance premium. Our store associates cannot take payments over the phone. All of our stores accept checks and money orders.

Depending on your plan, you also may be able to pay with a credit card. Contact your local store for payment information. See store locations. We offer a range of health insurance plans to fit your needs and budget. Most appointments take 1 hour. However, you may need more or less time depending on your specific needs.

In our stores, licensed associates offer personalized assistance to people searching for the right health insurance policy — for themselves or for their families.

Since the first Highmark Direct health insurance store location opened in , more than , people have visited our stores. We offer a personalized way to shop for health insurance; Here are some of the services that our Highmark Direct health insurance stores offer:. For information regarding health insurance plans offered by Highmark, prior to visiting your local Highmark Direct health insurance store, please visit Discover Highmark.

At DiscoverHighmark. We offer many convenient options in-store to help answer your customer service questions:. All of the details of what you need to bring to a consultation are included on our " What to Bring " page. We are unable to accept payments over the phone or cash. We have 13 Highmark Direct health insurance stores located throughout Pennsylvania.

At all locations, excluding Williamsport, Dickson City and Bartonsville locations, our stores are open Monday through Saturday from 9 am to 6 pm. Visit our store locator for addresses, phone numbers, and directions. PPO plans do not require members to receive initial care through a primary care physician. You can decide for yourself where to obtain care. You can use network providers, including specialists, and receive a higher level of coverage, or go to out-of-network providers and receive a lower level of coverage — and pay more -- for covered services.

The choice is yours. Once you enroll, you can review your benefit booklet online at the My Benefits page on the website. You will also have to pay for all of your medical expenses. For more information regarding penalties, please visit Healthcare. In addition to avoiding penalties and paying for all of your health care expenses, one of the smartest things you can do is to protect yourself and your family with the right health insurance coverage, even if you are healthy.

And what about staying healthy? Regular check-ups, vision care, maternity care and well-child care visits are important ways to take care of yourself and your family. Some individuals get health insurance coverage for themselves and their families through their employer as part of their benefits package.

Other individuals and families purchase coverage directly from a health insurance company. When you go to a health care provider, your health insurance identification ID card shows the provider which plan you have and the payment you are expected to make for the service.

The provider then sends a claim a bill for the services provided to your insurance company, and, if the service is covered, the insurance company pays the provider for the service. You will receive an Explanation of Benefits EOB statement from the insurance company that tells you the amount the insurance company paid for the service and any remaining amount that you owe the provider.

If you did not pay at the time you received care, you will receive a bill from the provider for the amount you owe. In addition to your premium , the amount you pay each month for your health insurance, you may have to share the costs of the services you receive.

For example, if the health insurance company pays 80 percent of the cost for a service, you would pay 20 percent coinsurance. The health insurance company pays the remaining cost. Can be before or after deductible. A Preferred-Provider Organization PPO gives you access to a network of participating doctors, hospitals and other health care providers.

If you receive care from a network provider, you pay a lower share of the cost. You can also choose to go to a doctor or hospital out of the network and pay a higher share of the cost for your care.

You do not need to have a primary care physician to coordinate your care. Your HSA can be used to fund your out-of-pocket medical expenses using tax-free dollars. A provider is any doctor, specialist, hospital or rehabilitation facility, for example, where you get health care. They also file claims for you.

Out-of-network providers do not have an agreement with a health plan. When selecting a health care coverage plan, you will want to research specific details about the plans you are considering, including:. Covered services — Most plans cover doctor visits, hospital stays, surgery and emergency care.

But if you want coverage for prescription drugs, vision or behavioral health, make sure the plan offers it. Deductible — How much of your health care expenses are you responsible for paying before the plan begins to cover your care? If you are covering family members too, do you need to meet more than one deductible? Or do expenses for all covered family members count toward a single deductible? Cost-sharing — What portion of the cost for services is paid by the plan and how much will you be responsible for?

Are those costs within your budget? If you use providers outside of the network, how much more will you pay for care? Preventive care — This usually includes yearly check-ups, mammograms, Pap tests, prostate exams, immunizations and well-child visits.

What kind of preventive care is covered? Are there limitations on that care, such as the number of visits per year? Maximums — Are there limits on how much the plan will pay for your care? Health Savings Account — To enjoy the tax advantages of a Health Savings Account, should you consider enrolling in a qualified high-deductible health plan?

There are lots of things you can do to improve your health, become an educated health care consumer and help control health care costs. With more providers than competitive plans, chances are good that your current physician and hospital are part of our extensive provider network. Find a Doctor, Hospital or Medical Provider to see if your provider is in our network.

Your PPO Plan has you covered no matter where you are. As a Highmark member, you enjoy all the services of BlueCard Worldwide. Your coverage travels with you through a worldwide network of care providers. For more details, please ask your local Highmark Direct health insurance store associate. To help make health insurance more affordable, the government offers two types of financial help to eligible households - depending on your household income and other factors.

If you qualify, a Premium Tax Credit may be applied in advance to lower what you pay in monthly premiums on any Health Insurance Marketplace plan. The amount of a Premium Tax Credit is based mostly on family size and income. Cost-Sharing Reductions CSR will lower your out-of-pocket costs that you may pay at the time of service for doctor's visits, lab tests, drugs and other covered services.

You can only get these savings if you enroll in a Marketplace Silver Metal Level plan.

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Provider Information Management forms are used to maintain provider accounts as well as begin the process to join Highmark's networks for new practitioners and offices. Practice information updates can be made with many of the forms below.

Please carefully read and follow the instructions contained within the individual form for submission. Highmark no longer requires a copy of the Medicare Welcome Letter for proof of Medicare eligibility for professional credentialing. Electronic Forms are submitted directly to Highmark via this website. Please feel free to take the time to research these items and input the responses as the form will not time out.

This form has been created for in-network provider use in order to comply with the No Surprises Act that was signed into law in December Changes to these elements will not be accepted via any other electronic form. Contact Us. Provider Directory. 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.

Quick Links: Manuals. Highmark Provider Manual. Medical Policy Medical Policy. Medical Policies. Medicare Advantage Medical Policies. Requiring Authorization.

This form has been created for in-network provider use in order to comply with the No Surprises Act that was signed into law in December Changes to these elements will not be accepted via any other electronic form. Contact Us. Provider Directory. 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.

Quick Links: Manuals. Highmark Provider Manual. Medical Policy Medical Policy. Medical Policies. Medicare Advantage Medical Policies.

Requiring Authorization. Pharmacy Policy Search. Message Center. Manuals Highmark Provider Manual. Provider Information Management Forms. Electronic Forms Electronic Forms are submitted directly to Highmark via this website.

Request for Assignment Account - Please use this form when you need to create a billing account for your practice.