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Plan Central Library - Archive 2014

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NEWS FOR ALL PROVIDERS

 

Date Posted Message
12/22/14 Ensure The Taxonomy Codes Linked To Your NPI Are Correct
12/18/14 New Screen Options On Heathway's Rapid Response System (RRS) Introduced January 3, 2015
12/17/14 Prior Authorization For Entyvio, Lupantea Pack, Plegridy, Ruconest, Sylvant, Vimizim
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
12/05/14 Health Options Provider Manual Now Online
12/01/14 Reminder To Rehabilitative And Habilitative Therapy Services Providers: SZ Modifier To Be Implemented 1/1/15
11/21/14 Don't Miss the Latest Issue of Provider News! It's Available Now
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
11/06/14 Update: Highmark Urges Health Care Professionals To Be Prepared To Detect and Treat Ebola Patients
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
10/21/14 Update: Highmark Blue Cross Blue Shield Delaware Urges Health Care Professionals To Be Prepared To Detect Ebola In Children And Adults
10/20/14 Highmark Delaware’S Medicaid Program Update: Fee Schedules Now Online
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
10/14/14 Highmark NaviNet System Downtime Scheduled for Oct. 17-18
10/02/14 Consumer Spending Account Change To EOB, EOP, Remittance And 835 (Electronic Remittance Advice) Beginning Oct. 20, 2014
10/01/14 Billing Disputes Made Under Terms Of The Provider's Contract With Highmark
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?
09/09/14 Simponi And Simponi Aria Will Require Prior Authorization Through Walgreens Specialty Pharmacy, Effective 9/15/14
09/04/14 Stay Informed By Reading Provider News – The Latest Issue Is Now Available!
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
07/31/14 IOP/PHP Outpatient Behavioral Health Program Providers: Authorization Requirement Postponed Until 9/2/14
07/28/14 Behavioral Health ACM Authorization Submission Manual Now Available
07/22/14 Rehabilitative and Habilitative Therapy Services Providers: SZ Modifier to be Implemented 1/1/15
07/16/14 Reminder: Always Verify Member Identification Number
07/10/14 Don't Miss an Issue of Our Newsletter! You Can Read the Latest Provider News Today!
07/10/14 Downtime Scheduled For Highmark’S Navinet System – July 11-14
07/02/14 Reminder: Manual Payment Process
07/01/14 Today’s The Day! The Physical Medicine Management Program Is Fully Implemented
06/13/14 Only Two Weeks Left Until The Full Implementation Of The Physical Medicine Management Program
06/04/14 Physical Medicine Management Program: Treatment Plans And The End Of Soft Implementation
05/23/14 Highmark Delaware To Assume Case Management For Newborns In Intensive Care
05/21/14 Highmark Health Names David Holmberg New President And Chief Executive Officer
05/16/14 Read The Latest Issue Of Provider News – It’S Available Now!
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 Blue Cross Blue Shield Delaware (Highmark Delaware) Moving Ahead To Ensure ICD-10 Preparedness, Despite Federal Decision
04/25/14 Enhancement To The Navinet Claim Investigation Process To Improve Provider Satisfaction
04/11/14 Highmark Delaware NaviNet System Downtime Scheduled for April 11-14
03/24/14 Stay Informed – Read The Latest Issue Of Provider News Now!
03/19/14 New Resource Available to Support Your Transition to ICD-10
03/13/14 Highmark Blue Cross Blue Shield Delaware Navinet System Downtime Scheduled For March 14-15
02/28/14 Physical Medicine Management Program: Soft Implementation Period Begins March 1
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
02/18/14 WEDI Offers Free ICD-10 Webinar Series
02/17/14 Physical Medicine Management Program Update: Care Registrations Can Now Be Submitted Online
02/14/14 Provider Service Experiencing High Call Volumes Today
02/13/14 Provider Service Line Closed Due To Weather
02/05/14 Provider Service Experiencing High Call Volumes Today
02/05/14 Highmark Delaware 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)
01/21/14 Jan. 22 Physical Medicine Management Workshop Cancelled
01/17/14 Physical Medicine Management Page Updated – Administrative Guide And FAQs Available
01/17/14 A Message Regarding Highmark Delaware's "Exchange" Products For 2014
01/15/14 Register Now For A Workshop On The Physical Medicine Management Program – Available Dates Are Jan. 21, 22 And 23!
01/13/14 Internet Explorer 11 May Be Causing Technical Issues When You Request Authorizations, View EOBs Via Highmark's Navinet® Site
01/09/14 Update: EFT Payments Issued From Dec. 14 Through Dec. 18, 2013
01/02/14 Highmark Delaware Introduces Physical Medicine Management Program

 

NEWS FOR PROFESSIONAL PROVIDERS

 

Date Posted Message
12/29/14 Eliminate Needless Authorization Requests That Can Cause Claims Processing Delays
12/23/14 Save Time, Energy By Making Sure A Service Or Medication Actually Needs An Authorization
12/23/14 Annual Hedis Medical Record Reviews Will Begin In February 2015
12/16/14 Sleep Study Update For Ordering Physicians Out-Of-Center (Home) Based Sleep Studies Eligible Option For Commercial Members
11/26/14 Prior Authorization No Longer Needed For Intravitreal Avastin
10/31/14 Supervising Physicians Must Sign Any Lab Orders
10/31/14 Low-Dose CT for Lung Cancer Screening to be Added to Radiology Management Program, Effective 1/1/15
10/31/14 Change To Office Site And Medical Record Review Evaluations, Effective 1/1/15
10/30/14 Introducing Medical Policy Update
10/22/14 Reminder: Procedure Code 83704 Is Considered Experimental/Investigational
10/07/14 Oct. 17, 2014, Deadline Approaching: Keep Assignment Account Data Current To Avoid Claim Rejections
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 24, 2014
08/05/14 Introducing Clinical Views – Our Clinical Journal For Delaware Physicians
08/01/14 Attention Ophthalmologists: Update on Avastin
07/23/14 Important: Keep Assignment Account Data Current To Avoid Claim Rejections
07/09/14 Effective 8/1/14, Partial Hospitalization And Intensive Outpatient Psychiatric Services Will Require Authorization
07/03/14 Effective 9/1/14, Highmark Blue Cross Blue Shield Delaware To Adjust Fees For Oxygen And Related Equipment
07/03/14 Hematologists/Oncologists: Camptosar, Gemzar, Aloxi and Neulasta To Require Authorization, Effective Sept. 1, 2014
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
06/25/14 Upload A Photo To Your Provider File And You Could Win $50 Gift Card
06/19/14 New Office Orientation Webinar Wednesday, June 27, 2014
06/02/14 Complete a Brief 2014 Systems Survey By June 8th For Chance To Win $500
05/21/14 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
05/08/14 We’re Now Accepting Candidates For Our CPMC Advisory Subcommittees
05/07/14 Hematologists/Oncologists: Four Chemotherapy Drugs To Require Authorization, Effective July 1, 2014
05/06/14 When Was The Last Time You Verified Your Provider Data?
04/17/14 New Office Orientation Webinar Wednesday, April 30, 2014
04/01/14 1500 Claim Form: Highmark Delaware Now Only Accepts The 02/12 Version
03/24/14 Two Drugs To Be Added To Prior Authorization Program, Effective 3/25/14
03/11/14 New Office Orientation Webinar Wednesday, March 26, 2014
02/12/14 New Office Orientation Webinar Thursday, Feb 27, 2014
02/10/14 Attention 1500 Filers: Be Sure To Use Correct Software Format When Completing New 02/12 1500 Claim Form
01/30/14 Attn Dentists: FEP Dental Claims Submission Reminder
01/10/14 New Office Orientation Webinar Wednesday, January 30, 2014

 

NEWS FOR FACILITY PROVIDERS

 

Date Posted Message
12/10/15 MATERNITY CLARIFICATION: VAGINAL DELIVERY CLAIMS SUBMISSIONS
12/18/14 Arzerra And Vectibix To Require Prior Authorization Before Administration, Effective Feb. 23, 2015
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
09/04/14 Highmark Facility Manual Debuts In Delaware!
08/12/14 Revision: Highmark Blue Cross Blue Shield Delaware's (Highmark Delaware) Third Quarter Updates For Outpatient Prospective Payment System (OPPS) Providers
07/11/14 Interqual 2014 Criteria To Be Implemented
07/01/14 Third Quarter Updates For Outpatient Prospective Payment System (OPPS) Providers, Bill Type 014X And 013X
05/20/14 Follow-Up Regarding Authorization Process For Chemotherapy Drugs
03/19/14 Clarification on Bill Type 014X and 013X
Last updated on 4/25/2017 9:58:27 AM

 

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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.