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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. The member's home plan may request Highmark obtain medical records from you.
The request will come to you in the form of a letter. Highmark will mail the letter to address on your Highmark file unless you have provided us with an alternate address to send records on a past request. 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.
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.
Addition Request to Existing Assignment Account — Please use this form when needing to update practitioners affiliation to existing assignment account information. Contract Upload Form Please only use this form to send Highmark a contract. Other uploads will not be processed and not be returned. Please use this form to indicate your DEA status. Return from Leave of Absence Form Please complete this form when the provider is returning from a leave of absence. This will allow for the reinstatement of network participation.
Request to be a Highmark Professional Pennsylvania Participating Provider - Please complete this form to have a Highmark Professional Pennsylvania Participating Provider contract sent to your billing practice. This form is for providers who are already enumerated. This form may not be used to terminate an individual commercial network. Highmark Provider Manual.
Medical Policy Medical Policy. Medical Policies. Medicare Advantage Medical Policies. Requiring Authorization. Pharmacy Policy Search. Message Center. Manuals Highmark Provider Manual. Medical Records: Tips to Improve Processing The member's home plan may request Highmark obtain medical records from you. You can expedite the process by following these simple guidelines: Promptly fax the records requested, along with the letter sent to you.
The letter serves as the fax cover sheet.
2 rows · Customer Service Phone Numbers. 8am to 5pm EST. The best time to call is WebCall Provider Services at , Monday–Friday, 8 a.m.–5 p.m., with any questions or concerns. Provider Services is here for you and is your first point of . WebProviders - Contact Us | Highmark Blue Shield of Northeastern New York EXPLORE PLANS EXPLORE PLANS EMPLOYER PROVIDED INSURANCE INDIVIDUAL & FAMILY INSURANCE MEDICARE DENTAL VISION PHARMACY FEP NYSHIP MEDIGAP MEMBER SERVICES MEMBER SERVICES FIND A DOCTOR MEMBER BENEFITS .