Information on this Provider Resource Center site is for members who have moved onto Highmark's systems.
For information related to members who have not moved onto Highmark's systems, please visit bsneny.com/provider.

Virtual Health

Highmark has offered virtual health services for many years, but the COVID-19 pandemic provided an opportunity for many of its members to try virtual health for the first time. The benefits of providing both members and providers with the efficiency and safety of virtual health are here to stay.

Virtual health services mean the use of synchronous or asynchronous telecommunications technology by a health care practitioner to provide health care services, including, but not limited to:

Virtual Visit Doctor

  • Assessment
  • Diagnosis
  • Consultation
  • Treatment and monitoring of a patient
  • Transfer of medical data
  • Patient and services

 

Virtual care can complement a physician’s practice by:

  • Improving patient outcomes
  • Increasing access to health care while providing scheduling flexibility and increased productivity
  • Reducing patient/office staff/clinician exposure to pathogens
  • Cutting down on hospital readmissions
  • Boosting patient engagement and satisfaction

To learn more about virtual health services, read the Highmark Health FAQs document.


Resources for Providers

  • Virtual Health Playbook - A Highmark Health guide that provides an overview of virtual health, guidelines on adopting the virtual health experience, tips for providers and additional resources.
  • Virtual Health Podcast - A 30-minute audio podcast meant to educate providers on adoption and awareness of virtual health care. You can read more about Virtual Health and listen to the podcast on the Highmark Health Digital Magazine.
    • About the Podcast: Highmark Inc. Senior Medical Director Dr. Timothy Law joined the Highmark Health Enterprise Virtual Health team to discuss what virtual health consists of, how to conduct a virtual health consult, share national trends, and answer common questions on coding, reimbursement, and more.

Telemedicine and Virtual Visits

Highmark differentiates between telemedicine and virtual visits. Telemedicine is services provided by Highmark-approved telemedicine vendors. Virtual visits are services provided by Highmark in-network providers within the scope of their license, deemed appropriate using their medical judgment, and delivered within the definition of the code billed. In-network providers do not need to utilize telemedicine vendor services to provide virtual services to Highmark members. These vendors are a separate option and benefit to certain members.


Provider Manual

Chapter 2, Unit 5 of the of the Highmark Provider Manual outlines telemedicine services including PCP, behavioral health and specialist visits. The Provider Manual also outlines benefits and approved vendors.


Reimbursement Policy

See Reimbursement Policy RP-046 Telemedicine and Telehealth Services for more detailed information and coding guidance. The policy outlines Highmark's reimbursement for telemedicine, telehealth, virtual-care, or eVisit services. 

Last updated on 8/25/2022 10:42:28 AM

 

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