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Plan Central Library - Archive 2016

All Providers | Professional | Facility

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NEWS FOR ALL PROVIDERS

Date Posted Message
12/28/16 Four Chemotherapy Codes To Be Added To The List Of Procedures Requiring Authorization, Effective March 1, 2017
12/21/16 Highmark Reaches New Agreement With Myriad Genetic Laboratories For BRCA Testing
12/15/16 Initial Credentialing Request Form Temporarily Unavailable
12/09/16 Laboratory Management Program Changes Effective Jan. 1, 2017, And Feb. 6, 2017
11/28/16 Focus Imaging Program Update
11/23/16 Highmark's Medical Management & Policy Holiday Schedule
11/21/16 naviHealth Expansion Delayed For ACA Members
11/18/16 2016 UDC Program Latest Monthly Progress Reports Now Available
11/11/16 News For All Highmark Health Options Providers: Clarification On LARC Products
11/10/16 Radiology Management Urgent Auth Requests
11/07/16 Highmark's Retrospective Chart Retrieval Program Launching For ACA Members
11/04/16 Reduce Claims Adjustments And Denials: Obtain Auths Prior To Service
11/04/16 Launch Date Of Enhanced Clinical Editing Processes Extended To 11/7/16
11/01/16 Verify Members’ Coverage Before Performing Digital Breast Tomosynthesis
10/31/16 Formulary Clarification: Effective Jan. 1, 2017
10/19/16 Practice's With Multiple Locations: Complete The "Service Facility Location" Field
10/19/16 Include The Correct Original Claim Number On Electronic Requests For Adjustment
10/13/16 Highmark NaviNet System Downtime Scheduled For October 14-15
10/11/16 2016 UDC Program Bonus Multiplier Extended to End of Program
10/07/16 FluMist Quadrivalent Removed from List of Covered Vaccines
10/04/16 Effective 10/14/16: Clarification Of Prescription Drug Coverage For Select Convenience Kit Products
10/04/16 Reminder: Ensure Accurate Patient Information Is Reported
09/30/16 Radiology Management Program Updates Effective 10/3/2016
09/30/16 Highmark Health Options Providers: Report Critical Incidents Within Two Business Days
09/30/16 Attention Physical Medicine Providers: Error In Healthways Authorization Requests
09/30/16 Attention All Providers: Highmark Following Industry Standard For NDC Submissions
09/30/16 Highmark Health Options Providers: Report Critical Incidents Within Two Business Days
09/28/16 Flucelvax Influenza Immunization Coding Guidelines Explained
09/21/16 2016 UDC Program September Monthly Progress Reports Now Available
09/21/16 Correction Underway To Address Lab Claims Processing Error
09/16/16 New InterQual Collection Form: Available In Navinet After Sept. 15, 2016
09/08/16 Reminder: Your 1099 Tax Forms Are Available Electronically Via Our NaviNet System
09/01/16 Payments For UDC Program Q2 2016 Submissions To Be Released
09/01/16 National Drug Codes Required For All Bluecard Medicaid Claims
08/15/16 Effective 10/14/2016 Clarification Of Prescription Drug Coverage For Select Convenience Kit Products
08/09/16 Now Available: Laboratory Management Program Administrative Guide
08/09/16 Highmark Removing 30-Day Deadline For Outpatient Behavioral Health Authorizations
08/09/16 Reminder: Cover Sheets For UDC Forms Not Needed
08/01/16 Upcoming Lab Management Program Web Orientation Sessions Aug. 17 And 19
08/01/16 Upcoming Lab Management Program Web Orientation Sessions Aug. 17 And 19
07/29/16 Effective Oct. 1, 2016, Allowable Rates For Commercial Products Will Be Adjusted
07/27/16 Highmark NaviNet System Downtime Scheduled For July 29, 2016
07/12/16 Highmark Navinet System Downtime Scheduled For July 15-16
07/12/16 Attention Providers Licensing with American Well To Provide Virtual Visits
07/11/16 Laboratory Management Program Resources Now Available
07/08/16 Highmark Delaware Partnering with Healthways to Streamline Its Claim Logic
06/28/16 Highmark To Launch Enhanced Clinical Editing Processes Starting 10/1/16
06/24/16 eviCore Lab Management Program Update: Prior Authorization Date Change
06/17/16 Authorization Requirements Removed From Certain 'C' Codes
06/17/16 Notify Highmark Of Banking Changes To Avoid EFT Payment Disruption
06/15/16 Attention All Providers: Avoid Claim Rejections On Injectable Drug Products
06/06/16 Updates To eviCore Lab Management Program
05/25/16 Changes To Question 2 In Healthways' Rapid Response System (RRS)
05/26/16 Spinal Injection Codes To Be Deleted From The List Of Procedures Requiring Authorization, Effective 5/23/16
05/02/16 Update: Enhanced Viewing In Navinet® Of Premium Delinquency Status For ACA Members
04/29/16 Highmark Implementing Lab Management Program July 1, 2016
04/29/16 Highmark Targets Health Care Fraud And Abuse
04/28/16 Highmark Delaware And Bayhealth Medical Center: Agreement Status
04/26/16 Cardiac Catheter Claims Incorrectly Rejecting
04/25/16 Reminder: Use Of Ultrasound In The Treatment Of Varicose Veins
04/18/16 Navinet EOBs, EOPs And Facility Remittances Will Be Delayed On Monday, April 18
04/18/16 Notify Highmark Of Banking Changes To Avoid EFT Payment Disruption
04/14/16 Highmark NaviNet System Downtime Scheduled for April 15
04/13/16 Servicing Blue Plan Medicaid Members
04/12/16 Important Note About Enhanced Viewing In Navinet® Of Premium Delinquency Status For ACA Members
04/08/16 Highmark Addressing Incorrect Bluecard® P5173 Claims Rejection Error For Screening Or Preventive Services
04/04/16 NDC Policy Reminder HCPCS Codes Requiring NDC Submission
04/01/16 321 Codes To Be Deleted From The List of Procedures Requiring Authorization, Effective 04/1/16
03/21/16 Highmark Staff Cannot Offer Coding Advice to Providers
03/17/16 Reminder: NaviNet is the Preferred Method of Obtaining Authorizations
03/08/16 Reimbursement News: All Network Providers Must Be Enrolled In EFT By March 31, 2016
03/04/16 Less HCPCS Codes Require NDC Submission
02/25/16 Highmark's Self-Service Tools: Easy & Efficient
02/25/16 Clarification On The Translation of the 270/271 Transactions
02/24/16 NaviNet Ref/Auth Inquiry Enhancements Coming
02/19/16 Implementation Delayed for NaviNet Ref/Auth Inquiry Enhancements
02/19/16 Medicaid Billing Requirements Beginning March 2016
02/18/16 Changes to Claim Adjustment Reason and Remark Codes on Electronic Remittances, Effective 2/12/16
02/12/16 Reminder: NDC Required on Claims Billed Under Medical Benefit
02/12/16 Highmark Delaware Urges Health Care Professionals to be Prepared to Detect and Treat Zika Virus Patients
02/09/16 New Effective Date For NaviNet Ref/Auth Inquiry Enhancements
02/05/16 Provider Manuals Now Include Highmark West Virginia
02/05/16 NDC Policy Changes
02/03/16 Seventeen Codes to be Added to List of Procedures Requiring Authorization, Effective 4/1/16
01/29/16 Navinet Ref/Auth Inquiry Enhancements Coming
01/29/16 Reimbursement News: All Network Providers Must Be Enrolled In EFT By March 31, 2016
01/29/16 Medicaid Programs Administered Through Blue Cross And Blue Shield Plans
01/15/16 Reminder: Use Online Research Tools Prior To Contacting Provider Service

NEWS FOR PROFESSIONAL PROVIDERS

Date Posted Message
12/12/16 Reduce Claim Denials: Report Surgery Code On All Anesthesia Claims
12/06/16 Quality Ratings Available In Find A Doctor
12/02/16 Providers To Receive E&M Coding Alerts From Change Healthcare's Coding Advisor Service
11/28/16 Colorectal Cancer Screening Kits Being Mailed To Select Highmark Members
10/27/16 Avoid Claim Denials By Keeping Your Assignment Account Data Up-To-Date
10/20/16 Reminder: The First Date Of Treatment Required
09/30/16 Reporting Emergency Services
09/20/16 Reminder: FEP Billing Guidelines For Immunization Administration
09/16/16 Attention Pharmacists: Administration Fee For Pharmacy-Based Vaccinations Readjusted To $10
08/24/16 Attention Mental Health Professionals: Change Healthcare Coding Advisor Program To Review Psychotherapy Codes
08/15/16 Anesthesia Reimbursement Change Effective Oct. 15, 2016
08/12/16 Billing Requirements For Dental Anesthesia
07/28/16 Change Healthcare Coding Advisor Program To Assist Highmark Delaware In Improving Evaluation And Management Coding Practices
07/21/16 Reimbursement Policies to Debut on Provider Resource Center on Aug. 1, 2016
06/15/16 Effective 8/15/16, Administration Fees For Pharmacy-Based Vaccinations To Be Adjusted
06/06/16 Highmark Accepting New Members For Medical Review Committee
05/23/16 Myriad Genetic Laboratories Will No Longer Be In The Highmark Delaware Network As Of June 1, 2016
04/19/16 Update: Authorizations Required For Pain Management Injections, Effective 4/1/16
04/01/16 Reminder: Authorizations Required For Pain Management Injections, Effective 4/1/16
03/24/16 Highmark Accepting New Members For Medical Review Committee
03/18/16 Updated Locum Tenens Form Now Available
03/04/16 Register Today: 2016 UDC Program Training Webinars Begin March 28
02/29/16 2015 Unconfirmed Diagnosis Code (UDC) Program Q4 Additional Compensation Payments to be Delayed
01/13/16 Annual HEDIS Medical Record Reviews Will Begin In February
01/12/16 P4V Partners: True Performance Value-Based Reimbursement Sessions Set for Jan. 19-22
01/07/16 Professional Billing Guidelines for Multiple Same Day Services
01/06/16 Two Weeks Remaining In The 2015 UDC Validation Program

NEWS FOR FACILITY PROVIDERS

Date Posted Message
12/16/16 Update Regarding Enhanced Inpatient Review And Discharge Planning
09/27/16 Reminder: Facilities Must File Outpatient Claims Using Correct Bill Type
08/31/16 Billing Lab Tests Without The L1 Modifier
08/30/16 Enhanced Inpatient Review And Discharge Planning
05/10/16 Change To Vaginal Delivery Claims
04/21/16 Reminder: Reporting Patient's Reason for Visit on ER Claims

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Last updated on 4/11/2017 10:39:39 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.