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Plan Central Library - Archive 2015

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NEWS FOR ALL PROVIDERS

Date Posted Message
12/22/15 PCP & RETAIL Clinic Virtual Visit Fliers Available For Your Patients
12/18/15 Reminder: Network Providers Are Required By Contract To Notify Highmark Of Any Status Changes
12/10/15 Medicare Advantage: Ambulance Transport Services to Site of Medical Care Issue Identifed
12/10/15 NOC Codes Requiring Medical Review May Reject For Additional Information
12/08/15 Update Your Lactation Counseling Services Information Via Navinet®
12/07/15 Reminder: Care Registration Resets For The Physical Medicine Management Program Every Calendar Year
12/02/15 Highmark NaviNet System Downtime Scheduled for December 4-5
11/25/15 Medical Management and Policy Holiday Operating Hours
11/23/15 Be More Efficient: Take Advantage of Electronic Funds Transfer (EFT)
11/19/15 Highmark Delaware's Remaining 2015 And January 2016 Holidays
11/13/15 Reminder: National Drug Code (NDC) Requirement Begins Nov. 16, 2015
11/11/15 Annual Scorecards Available For Physical Medicine Provider Pathways Participants
11/10/15 Preventive Services Denial Now Corrected
11/05/15 Preventive Services Denial Identified And Currently Under Review
10/28/15 Obstetrical Ultrasound Criteria Revised; Correction To Obstetrical Ultrasound Article Published In September 2015 Medical Policy Update
10/28/15 Highmark Health Options Announces Enhanced Clinical Editing Processes
10/27/15 3-D Mammograms Eligible
10/26/15 In 2016, Your 1099 Tax Form from Highmark Delaware Will Be Available Electronically Via Our NaviNet® System
10/21/15 List Of Procedure Codes Requiring NDC Information Available Now
10/21/15 Attention Private Duty Nursing Providers: Authorizations And Predeterminations For Private Duty Nursing Care
10/13/15 Provider Service Telephone Lines: New Self-Service Prompts Being Rolled Out
10/09/15 PMMP Providers: Avoid Authorization Rejections
10/07/15 Highmark Navinet System Downtime Scheduled For Oct. 9-10
10/01/15 ICD-10: Auth Submissions Corrected: All Auth Submission Options Operational
10/01/15 ICD-10: Highmark Delaware Unable To Accept ICD-9 Auth Submissions - Date Of Service 9-30-2015 And Prior
09/30/15 ICD-10: Navinet Authorization Submissions Decimal Not Required: ICD-10-CM Codes
09/25/15 PMMP Providers: ICD-10 Update Regarding New Forms
09/25/15 Clinical Coding Testing Results To Date
09/21/15 ICD-10: Highmark Delaware Testing Endeavors: Testing Efforts Shared With Network Providers!
09/15/15 Navinet Allowance Inquiry Refresher
08/10/15 All Drug Claims Billed Under Medical Benefit Must Include NDC, Effective With Claims Submitted On Or After 11/16/15
08/10/15 Are You Prepared for ICD-10? Take the ICD-10 Readiness Survey Today!
07/24/15 Revisions to Commercial Medical Policies L-34 and S-230 Being Postponed
07/24/15 Clinical Views - Best Practice Source For Physicians And Clinical Staff - Issue 2, Now Available
07/20/15 CMS ICD-10 Quick Start Guide Added To Tool Kit
07/20/15 Highmark Delaware Works To Curtail Health Care Fraud
07/16/15 Reminder: Change In Planned Test/Procedure Requires New Auth
07/10/15 Preventive Services: For Members Whose Recorded Gender Does Not Match The Gender For Certain Preventive Service
07/10/15 Clarification: Health Care Reform And Contraceptive Coverage
07/10/15 New Options Available: Provider Service Telephone Lines
07/08/15 Navinet Downtime July 10, 2015
06/30/15 Dosing Limits For Stelara Enforced
06/25/15 Vedolizumab (Entyvio®) Medical Policy Delayed Until Further Notice
06/19/15 Highmark Health Options: Submit Authorizations Electronically Via Navinet
06/19/15 Attention Navinet-Enabled Providers: Continue Stacking Services
06/18/15 Highmark Health Options: Submit Authorizations Electronically Via Navinet
06/17/15 Ensure Accurate Patient Information Is Reported
06/03/15 Highmark Health Options: Long Term Services And Supports To Require Authorization, Effective June 15, 2015
06/02/15 Highmark Inc., BCNEPA Merger Gets Approval From Pennsylvania Insurance Department
05/29/15 Use Electronic Provider Access Portal For Bluecard Authorization Request
05/28/15 Correction to Effective Date for Medical Policy Bulletin Z-13, Emergency Medical Care Changes: Hmk Z-13 Will Be Effective July 27, 2015
05/14/15 Notice Regarding Healthways Systems Issue
05/11/15 Attention Physicians Who Perform MOHS Surgery: Correction Underway To Address Mohs Claims Processing Issue
05/06/15 Register Now for the Quality Blue P4V Regional Care Delivery Model Forum on May 27
05/06/15 Predeterminations Recommended for Private Duty Nursing
05/04/15 Updated Physical Medicine Management Program Administrative Guide is Now Available Online
04/24/15 Highmark Delaware Navinet System To Be Offline Overnight April 25 to 26
04/22/15 Attention Air Ambulance Service Providers: Air Ambulance Claims Filing Rules, Requirement To Report Point Of Pickup
04/17/15 Reminder: Radiation Therapy Authorization Program Begins April 20, 2015
04/17/15 Effective 6/1/15, You Must Use Navinet To Add/Remove Practitioners On File With Highmark Blue Cross Blue Shield Delaware
04/16/15 Navinet Authorization Transaction Enhancements Coming Soon
04/16/15 Highmark Delaware Navinet System Downtime Scheduled For April 17-18
04/15/15 New Tool Kit May Offer Assistance With ICD-10 Transition
03/25/15 Radiology Site Selection Pilot Program Delayed
03/20/15 To Launch 3/23/15, Pilot Program Will Educate Selected Members About Lower-Cost Imaging Providers
03/18/15 Highmark Navinet System Downtime Scheduled For March 20-21
03/18/15 Lemtrada Coding Tip
03/10/15 Provider Resource Center HIPAA Link Updated To: ICD-10/HIPAA
03/09/15 It’s Here! A New Issue Of Provider News Is Online Now, Read It Today!
02/19/15 Radiation Therapy Authorization Program: Begins On April 20, 2015
02/19/15 Important Changes Effective 4/20/15: Provider Assignment of Liability
02/08/15 Highmark's Statement On Anthem Security Breach
02/04/15 Highmark Retains 5.3 Million Members For 2015
02/02/15 Highmark Navinet System Downtime Scheduled For February 6-7
01/27/15 Clarification Regarding NaviNet Auth Submission Process For Xgeva, Prolia
01/26/15 Medical Policy Update Now Online – Read This Issue Today!
01/12/15 The Information You Need – All In One Place. Latest Issue Of Provider News Now Available!

NEWS FOR PROFESSIONAL PROVIDERS

Date Posted Message
12/18/15 Program For Self-Administered Injectable Or Oral Biotechnology Drugs Starts 1/1/16
12/17/15 Highmark ACA Retrospective Chart Retrieval Program to Launch
12/08/15 Attention PCPs: Important UDC Program News
11/24/15 Unconfirmed Diagnosis Code (UDC) Program Payments To Be Released By Dec. 7, 2015
11/24/15 Reminder: Billing Guidelines For Medical Aid Units
11/18/15 Unconfirmed Diagnosis Code (UDC) Program Progress Reports Issue Identified On Two Tabs
11/11/15 Unconfirmed Diagnosis Code (UDC) Program Progress Reports Now Available
11/11/15 Supporting Health Care Transparency With Physician Quality Measures (PQM)
11/02/15 Reminder For Prescribers: Several Drugs Will Have New Prior Authorization Clinical Restriction, Effective Dec. 1, 2015
10/21/15 Tips For Submitting Authorization Requests For Eylea, Macugen, Lucentis
09/29/15 Highmark Delaware's Prevention Campaign
09/22/15 Unconfirmed Diagnosis Code (UDC) Program Information Related to ICD-10 Compliance
09/22/15 Federal Employee Program Dental Providers: Claim Submission Reminders
09/15/15 Providers Requesting Authorization For Non-Highmark Members Via Fax
09/14/15 Understanding When To Use New Patient Versus Established Patient Evaluation And Management Codes
09/11/15 Attention Oral Surgeons: Good News! You Can Now Submit Electronic Oral Surgery Claims Directly To Highmark Delaware
08/21/15 Unconfirmed Diagnosis Code Program Update
08/18/15 Initiating Authorization Requests For Certain Drugs: Eylea, Macugen, Lucentis
08/10/15 Streamlined Access To Network Fee Schedules On The Provider Resource Center
08/07/15 Unconfirmed Diagnosis Code Validation Program Launched Aug. 4, 2015
08/05/15 Routine Chlamydia Screening: Encourage Your Patients To Get Tested
08/03/15 Attn: Physicians Who Prescribe Inhaled Antibiotics Used for Cystic Fibrosis
07/24/15 Earn Free CMEs: Online Clinical Documentation Improvement Series Workshops Begin in August
07/15/15 FOCUS Reminder: For Primary Care Physicians (PCPs)
07/15/15 EPSDT Program Summary For Highmark Health Options
06/01/15 Highmark Delaware Announces Adjustments to Reimbursement Rates, Effective 7/1/15
05/27/15 Great News – Navinet Enhancements Make Drug Authorization Process Faster Than Ever!
05/19/15 Effective July 14, 2015, New Quantity Level Limits For Certain Prescription Drugs
05/12/15 Please Complete National Behavioral Health Accessibility Questionnaire
05/08/15 Attention Physicians Who Perform MOHS Surgery: Correction Underway To Address Mohs Claims Processing Issue
04/15/15 National Healthcare Decisions Day Puts Focus On Advance Care Planning
04/01/15 Highmark Delaware To Require Prior Authorization For Concurrent Use Of These Drug Types
04/01/15 Coverage of Numerous Topical Patches/Gels to be Discontinued for Commercial Members
03/20/15 Notice Regarding Drug-Specific Surveys For Prescriptions That Require Authorizations
02/27/15 Attention Prescribing Physicians: Important News About Cymbalta
02/24/15 We're Making The Drug Authorization Process Faster Than Ever With Navinet!
02/12/15 New Reminder Message On Submission Form Helps Avoid Unnecessary Auth Requests For At-Home Sleep Studies
02/11/15 New Office Orientation Webinar Wednesday, February 25, 2015
02/03/15 Claims Denials For Code 99213 Could Be Inaccurate – Impacted Claims Submitted On 12/19/14
01/13/15 An Opportunity To Become Part Of A Practice Transformation Network
01/12/15 Attention Cardiologists: Highmark Now Accepting Candidates For Pharmacy And Therapeutics Subcommittee

NEWS FOR FACILITY PROVIDERS

Date Posted Message
12/10/15 MATERNITY CLARIFICATION: VAGINAL DELIVERY CLAIMS SUBMISSIONS
12/03/15 Starting 1/1/16, PO Modifier Required On All Claims For Services Furnished At Off-Campus Provider-Based Departments
09/25/15 ICD-10: ER and Observation Services, Spanning Compliance Date, Clarified
08/10/15 Streamlined Access To Network Fee Schedules On The Provider Resource Center
06/03/15 Eight Injectable Drugs To Require Authorization, Beginning In June/July 2015
04/06/15 Eight Injectable Drugs to Require Authorization, Beginning in June 2015
02/11/15 Important Notice: Urgent Inpatient Requests via Authorization Submission Transaction Reviewer Comments Not Available for Some Facilities
02/10/15 Highmark Facility Manual Completed For Delaware
01/30/15 Robotic Surgical System Not Eligible For Reimbursement, Claims To Be Audited
01/23/15 Mandatory Prior Authorization For Eight Chemotherapy Drugs Begins March 30, 2015
Last updated on 4/11/2017 12:58:00 PM

 

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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.