PROVIDER Contact Web Claims Mailing Address 3 Claim Submission Procedures 3 Claim Coding Software 5 Coordination of Benefits 6 providers at the claim, practitioner, and practitioner-specialty level. Highmark Health Options is an independent licensee of the Blue Cross Blue Shield Association, an association of independent Blue Cross Blue Shield Plans. WebIf you need a claim form or help on how to file a claim, call Blue Cross NC's Customer Service at 1-877-258-3334 or write to: Blue Cross NC Customer Service P. O. 1-866-231-0847 (TTY 711) Get help anytime with mental health or substance use issues. If you wish to begin to submit claims electronically, you may contact the EDI Operations support line at 1-800-992-0246 to speak with a representative. Highmark Inc. or certain of its affiliated Blue companies also serve Blue Cross Blue Shield members in 29 counties in western Pennsylvania, 13 counties in northeastern Pennsylvania, the state of West Virginia plus Washington County, Ohieo, th state of Delaware and 8 counties in western New York. Transportation to and from appointments. highmarkbcbs Box 211713 Eagan, MN 55121. WebHome Health/Home Infusion Therapy/Hospice: 888-567-5703. Provider WebWelcome to the Highmark Provider Portal. highmarkbcbs WebHighmark BCBSWNY can help you get the most out of your Medicaid benefits. Provider Claim Please note that the 180-day appeal deadline will still apply if you choose We will retain the information in our system in accordance with applicable law and our Data Protection Policy:https://www.highmark.com/hmk2/gdpr.shtml. 1-877-327-1395, Provider Relations & Contracting/Network Management, 716-887-2054 or Musculoskeletal (eviCore): 800-540-2406. Contact us | Providers | Independence Blue Cross (IBX) If it begins with a 1 and includes 10 digits, your portal has moved! Highmark (Pennsylvania and Delaware) 7248 Tilghman St. Allentown, PA 18106. Medicaid or Child Health Plus member, please login here. Box 898845 Camp Hill, PA 17089 -8845 Children s Health Insurance Plan (CHIP) PPO Plus . Convenient self-service prompts available. Highmark Medicare WebProvider Contact. Your email address and phone number may be used to contact you. Highmark Blue Shield Highmark Convenient self-service prompts available. 7: CLAIMS, BILLING, AND REIMBURSEMENT (ii) when required valid requests by law enforcement. WebIf you wish to begin to submit claims electronically, you may contact the EDI Operations support line at 1-800-992-0246 to speak with a representative. You have the right to submit evidence or allegations of fact or law, in person or in writing. Central, Eastern and Northeastern Regions Only - Highmark About Highmark. NaviNet gives users real-time access to Highmark's membership, claims and provider and payment systems, making your job easier. Please enter your ZIP code or return to highmark.com. But if WebSelect Language ; Select Language; Font size dropdown. Message Center; Account Settings; Need Help? Fields marked with an asterisk (*) are required. Phone: 800-788-5661 Committing to the highest standards encompassing every aspect of our behavior including high moral character, respect, You can contact us at: Highmark Health Options Appeals and Grievances P.O. WebFILING INSTRUCTIONS 1. If you are not Find a Prescription Drug. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Claims. We have redesigned the Highmark Provider Manual to make it easier for you to view and find important information, policies, and procedures for all providers participating in our networks in Delaware, New York, Pennsylvania, and West Virginia. Need Help? WebUse of Self-Service Tools Now Required For Routine Claims Inquiries. 1-800-676-BLUE (2583). Disaster or Emergency Information. Federal Employees - Contact Claims - Highmark Blue Cross Blue Shield Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. click here to log in Highmark Blue Cross Blue Shield Delaware is an independent licensee of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. Site Map. Earning trust by delivering on our commitments and leading by example. WebDental Providers. Mental Health/Substance Use Disorder Precertification. WebSelect Language ; Select Language; Font size dropdown. The Highmark Provider Manual is your primary reference guide to Highmark. Service for answers. Contact Us - Provider Resource Center Amerigroup Partnership Plan, LLC is an independent company providing management services on behalf of Highmark Blue Cross Blue Shield of Western New York. Freedom Blue PPO is a Medicare Advantage Preferred-Provider Organization that gives you coverage for every need - health, prescription drugs, routine dental, vision, hearing and preventive care. The purpose of this Data Protection Statement is to notify you of the practices that will govern the processing of your personal data and to obtain your explicit consent for the processing of your personal data consistent with it, in particular in accordance with the legal requirements of the European Unions (EU) General Data Protection Regulation (GDPR): The personal data collected may include your address, city, postal code, country, phone number, email address, IP address, as well as any other personal information you choose to provide (Personal Data). Legal Information. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. All references to Highmark in this document are references to the Highmark company that is providing the members health benefits or health benefit administration. WebStaying Up to Date with the Highmark Provider Manual; Claims & Billing New and Updated Reimbursement Policies Watch for Updates to Highmarks List of Procedures Requiring Authorization Administrative News Quarterly Formulary Updates Available Online Staying Highmark Blue Shield is an independent licensee of the Blue Cross and WebThe implementation of ICD-10 results in more accurate coding, which improves the ability to measure health care services, enhance the ability to monitor public health, improve data reporting, and reduce the need for supporting documentation when submitting claims. Fax: 717-635-4590. Blue Shield coverage, there are a variety of ways to contact Customer WebBlueCard. It's: Highmark Health Fifth Avenue Place 120 Fifth Avenue Pittsburgh, PA 15222-3099 (412) 544-7000 Fields marked with an asterisk (*) are Highmark Inc. is a national, diversified health care partner based in Pittsburgh that serves members across the United States through its businesses in health insurance, dental insurance, vision care and reinsurance. Refer to Watch Plan Central and the Provider Resource Center for more information regarding this function in the coming weeks. Regular; Large; Largest; Font size dropdown. Highmark Blue Shield Contact Us - Highmark Web1-855-412-8001: Provider Services. As part of the No Surprises Act and Highmarks Provider Directory requirements, you must verify your information with Highmark every 90 days to remain in our directory. 257 W. Genesee Street Medical Plans; Pharmacy; Balanced Funding; That means lower out-of-pocket costs for members when they use in-network providers and reduced claim costs for clients. Provider WebContact Us Contact Us If you suspect fraud, contact your local Financial Investigations & Provider Review Department within Highmark. For trading partners that have not yet completed the transition. All Rights Reserved. Legal Information. For questions about our Pittsburgh location, please email us at PittsburghConnectionCenter@HighmarkWholecare.com or call 412-690-7400 (TTY 711).. For questions about our Harrisburg location, please email us at The Blue Cross and Blue Shield symbols are registered marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. Contact Us; My Location; Login; Customer Service 1 (800) 241-5704 Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Provider Contacts that transmits to, or (ASC X12/005010X221A1 Health Care Claim Payment/Advice (835)) Provider Taxonomy Codes (ASC X12N/005010X222A1 Health Care Claim: Population Health Toolkits and Transitions of Care Module Now Available, New Claims Status Inquiry Attachment Feature in NaviNet, Highmark Product News:Important Updates Coming for 2022, Watch for Updates to Highmarks List of Procedures Requiring Authorization, Quarterly Formulary Updates Available Online, Staying Up to Date with the Highmark Provider Manual. Complete the Provider Communications Email Sign-up Form to receive email updates with the latest information, including Partners in Health UpdateSM. Contact Highmark Blue Cross Blue Shield Provider Directory. WebClaim Filing Addresses Central, Eastern and Northeastern Regions Only Claim Submission Postal Addresses If you are not submitting claims electronically, use the Provider EDI Reference Guide Highmark EDI Operations April 5, 2010 To submit information to credential a provider for one of Highmark Blue Shields networks: In the Western, Central and Eastern PA Regions: fax documents to 1-800-236- But if you need to contact us, below are the telephone numbers exclusively for providers. Precertification. 800-242-0514 Hours of Availability: Administration of the Flu and COVID-19 Vaccinations, Changes to Highmark's 2022 Preventive Health Guidelines, Breast Cancer Screening and Adjunct Imaging in Single Visit Offers Increased Convenience and Compliance, Updates to Highmarks List of Procedures Requiring Authorization, Quarterly Formulary Updates Available Online, Staying Up to Date with the Highmark Provider Manual. Notwithstanding the above disclosures, we will disclose the Personal Data we collect from you under the following circumstances: We use third-party service providers to process Personal Data, including, without limitation, for information storage and other similar purposes. Highmark Blue Cross Blue Shield of Western New York How do I obtain a HIPAA Certificate? Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Our commitment to partnering with our participating providers is vital to providing quality coverage for our members. Highmark Blue Shield is an independent licensee of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. 2021 Highmark Blue Cross Blue Shield of Western New York is a trade name of Highmark Western and Northeastern New York Inc., an independent licensee of the Blue Cross Blue Shield Association. Contact WebImportant Legal Information:: Highmark Blue Cross Blue Shield, Highmark Choice Company, Highmark Health Insurance Company, Highmark Coverage Advantage, Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. New Address Change Form - Provider Resource Center Provider Directory. Highmark members looking for a provider will not have access to providers who are no longer listed in our directory. Find a Prescription Drug. Need Help? Buffalo, NY 14202-2657, Mailing Address: Highmark Integrity. Highmark will no N1^PR^HIGHMARK BLUE SHIELD N3^120 FIFTH AVENUE Highmark Blue Cross Blue Shield serves the 29 Contact Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Provider Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. CLAIMS DECEMBER 2014 . Notes: This consent is given voluntarily and can be revoked at any time in writing by sending an email to PrivacyInternational@HighmarkHealth.org If you want to exert your withdrawal right or your rights to access, rectify, block, transfer or delete your personal data pursuant to the GDPR, please contact us and provide us at least with your full name, address and the data processing you are inquiring about. Additionally, we will be announcing a new NaviNet function in early 2022 that will allow you to verify and edit your information online without having to submit a form or call us. Phone:800-333-8451or 800-314-0025 Claims and Payment Policies - Highmark Health Options HIGHMARK 1-800-547-3627. WebTelephone. Buffalo, NY 14240-0080. Claims PROVIDER P.O. Site Map. If you are not satisfied with our data processing you have the right to lodge a complaint to the data protection authority in your country of residence. WebPennsylvania. Small Business. Complete all items below including your signature and date.All of the information is essential for prompt and accurate processing of your claim(s). Highmark Provider Web Highmark is a registered mark of Highmark Inc. Chapter 5 Claims Submission Unit 2: Claims - Highmark Blue Please use NaviNet for all of your routine eligibility, benefit, and claim inquiries. Provider Service Highmark adheres to the Centers for Medicare and Medicaid Services (CMS) coverage determinations for Medicare Advantage (MA) membership. WebMailing Address: Highmark Blue Cross Blue Shield of Western New York P.O. Site Map. WebHighmark Blue Shield P.O. Regular; Large; Largest; Font size dropdown. Box 535191 Pittsburgh, PA 15253-5191. Last updated: July 28, 2021 Understanding Your Rights 1. Convenient self-service prompts available. Please Highmark Blue Shield WebQuality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find.BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. Select Language; Select Language For more information, call Provider Services at 1-844-325-6251 MondayFriday, 8 a.m.5 p.m. picture_as_pdf Fee Provider services For provider questions and claims issues: Phone: 1-866-231-0847. Highmark Blue Cross Blue Shield is an independent licensee of the Blue Cross and Blue Shield Association. Hours of operation: 8:00 a.m. to 4:30 p.m. EST. Provider Resource Center All Languages | This page was last updated 07/15/2023. to My Shield Online and then click "Messages." All reasonably appropriate measures will be taken to prevent disclosure of your Personal Data beyond the scope provided directly or indirectly herein or as may be reasonably inferred from the content contained in this notice or the website. How can I get to a Customer Service walk-in site? Community Blue Box 890062 Camp Hill, PA 17089-0062 QCE Security 65, 65 Special, and WebThe Company could not have accomplished this without the cooperation of providers, office and medical assistants who prepare and submit claims to Highmark Blue Shield. Highmark P.O. Solutions. Quick Reference Directory of Pennsylvania Blue Shield Be sure to have the subscriber or member identification number available when calling. highmarkbcbs Use our 24/7 NurseLine to get reliable medical advice any time, day or night. Only Providers who have claims linked to Letters can login. PROVIDER INQUIRY FORM. Box 890062 Camp Hill, PA 17089-0062 For BlueCard POS where Highmark is not the WebWant to Learn More About the Highmark Wholecare Connection Center? Provider Directory. PO Box 80 Providers are reminded not to send Highmark a check for a refund of a claim overpayment. Camp Hill, PA17089-0138 1-800-535-5266. My Location. Wheeling, WV 26003 . Fax: 1-800-964-3627. PROVIDER DATA SERVICES/CREDENTIALING INFORMATION 1-866-763-3224, Option 4. 257 West Genesee Street Plan Name and Address and Policy or Medical Assistance Number 9. 2022Highmark Blue Cross Blue Shield of Western New Yorkis a trade name of Highmark Western and Northeastern New York Inc., an independent licensee of the Blue Cross Blue Shield Association. Contact Highmark Inc. d/b/a Highmark Blue Shield and certain of its affiliated Blue companies Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Parkersburg, WV 26102 Pennsylvanias Telephonic Psychiatric Consultation Service Program for CHIP Members, Population Health Transitions of Care Module Now Available for CME Credits, Watch for Updates to Highmarks List of Procedures Requiring Authorization, Quarterly Formulary Updates Available Online, Staying Up to Date with the Highmark Provider Manual. This website does not display all Qualified Health Plans available through the Health Insurance Marketplace website. Have questions about benefits or claims? Entire contents document.write(new Date().getFullYear()) Highmark Health. Security | Privacy | Terms of Use | Notice of Non-Discrimination and Translation Assistance, Notice of Non-Discrimination and Translation Assistance. Highmark Blue Cross Blue Shield West Virginia, Highmark Blue Cross Blue Shield of Western New York, Highmark Blue Shield of Northeastern New York. Credentialing and re-credentialing application status inquiries, Prescription drug prior authorization 24 hours a day, 7 days a week, Provider Services (direct all inquiries or issues directly to Independence Administrators), For Keystone Health Plan East Members with Caring Foundation benefits. Update: Stabilize and Transfer OON Protocol Will Not Be Reinstated. Contact Us. Provider Claims WebEMAIL ADDRESS: edisupport@highmark.com When contacting EDI Operations have your Trading Partner Number and Logon ID available. Amerigroup Partnership Plan, LLC brinda servicios administrativos para Medicaid administrado de Highmark Blue Cross Blue Shield of Western New York. [{"id":39447,"versionId":6468,"title":"Highmark Transitioning From NaviNet to Availity","type":4,"subType":null,"childSubType":"","date":"6/26/2023","endDate":null,"additionalDate":null,"imageUrl":null,"url":null,"urlText":null,"description":"\u003cp\u003e\u003cspan\u003eHighmark is replacing its existing provider portal, NaviNet\u003csup\u003e\u0026reg;\u003c/sup\u003e, with Availity\u003c/span\u003e\u003csup\u003e\u0026reg;\u003c/sup\u003e\u003cspan\u003e\u0026nbsp;Essentials later this year.\u003c/span\u003e\u003cspan\u003e\u0026nbsp;\u003c/span\u003e\u003ca href=\"https://content.highmarkprc.com/Files/NewsletterNotices/SpecialBulletins/sb-availity-transition-announcement-62623.pdf\" target=\"_blank\" rel=\"noopener noreferrer\" title=\"CLICK HERE\"\u003eCLICK HERE\u003c/a\u003e\u003cspan\u003e\u0026nbsp;to read more about the upcoming\u0026nbsp;transition.\u003c/span\u003e\u003c/p\u003e","longDescription":null,"visible":false,"archive":false,"liveStatus":2},{"id":39210,"versionId":6468,"title":"Highmark Post-PHE Changes","type":4,"subType":null,"childSubType":"","date":"4/7/2023","endDate":null,"additionalDate":null,"imageUrl":null,"url":null,"urlText":null,"description":"\u003cp\u003eWith the expiration of the PHE, Highmark has started the process of updating COVID-19-impacted policies and procedures. Corporate Address: Highmark Blue Cross Electronic data interchange Highmark Blue Cross Blue Shield. Highmark Inc. or certain of its affiliated Blue companies also serve Blue Cross Blue Shield members in 29 counties in western Pennsylvania, 13 counties in northeastern Pennsylvania, the state of West Virginia plus Washington County, Ohieo, th state of Delaware and 8 counties in western New York. 6/27/2023. West Virginia WebClick on the link to find contact information for Highmark Blue Shield of Northeastern New York in Albany including email, For Providers child pages; For Providers parent page; For Providers FILING FOR BORDER COUNTY MEDICARE CLAIMS ANCILLARY CLAIMS FILING MANDATE OUT-OF-AREA POLICY SEARCH TOOLS & RESOURCES Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in Login Highmark Provider Toggle Menu. Provider ATTN: FEP Department All references to Highmark in this document are references to the Highmark company that is providing the members health benefits or health benefit administration. Service for answers. Member Service Please mail your dental claims to: Blue Cross Blue Shield of North Carolina Attn: Dental Blue Claims Unit PO Box 2100 Winston-Salem, NC 27102 Providers with internet access will find helpful information online at highmarkbcbs.com . Highmark Wholecare serves a Medicaid plan to Blue Shield members in 13 counties in central Pennsylvania, as well as, to Blue Cross Blue Shield members in 14 counties in western Pennsylvania. WebHighmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Contact your designated Independence Provider Network Services (PNS) team contact. Please contact Provider Services or your Provider Account Liaison Claim Status Inquiry - Find additional detail on your claim. Highmark Contact Us. These services providers are located in the United States. To send a secure message to Customer Service through our Web site, WebSelect Language ; Select Language; Font size dropdown. (iii) for purposes relevant to corporate policies or litigation to the extent permitted under applicable law or when it is prescribed in GDPR or other applicable law. How can I reach Customer Service by using the Internet? Information current and approximate as of December 31, 2018. TTY: 711. Fri., 8 a.m. 5 p.m. 1-800-992-0246: Independence Administrators Provider Services (direct all inquiries or issues directly to Independence CASE WebHighmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Empire BCBS provider phone number and claim address updated from different authorized resources and try to keep correct and latest updates. Box 7026 Wheeling, WV 26003 Customer Service. If you have questions about your Highmark Mental Health/Substance Use Disorder Precertification. These service providers will be bound by sufficient guarantees to implement appropriate technical and organizational measures in such a matter that their processing will meet the requirements of applicable law. Local: (716) 884-2800 a reply to your My Shield Online Message Center within 48 hours. WebHighmark EDI Operations Mon. If the claim is denied or final, there will be an option to dispute the claim. This document addresses how trading partners conduct professional claim, institutional claim, claim acknowledgment, and claim payment advice HIPAA standard electronic transactions with IBC in the 5010 version. WebContact Highmark Blue Cross Blue Shield of Western New York. highmarkbcbs highmarkbcbs