Case Management Referrals

You can submit automated referrals for Clinical Care and Wellness (CC&W) case management programs via NaviNet^® . This feature will help connect Highmark members with chronic conditions and complex medical needs with the right clinical support.

To access this feature:

• Log into NaviNet and select the appropriate Health Plan.
• Under Workflows for this Plan on the left menu, click Case Management Referral and Inquiry. This will take you to the Clinical Care & Wellness page.
• Click the Create New Referral button under Submit New Referral to CC&W.
• Follow the steps to create and submit the referral.

The 2023 Reference Guide to Highmark Member Programs — complete with useful information and helpful resources — is available on the Provider Resource Center (PRC) to further your understanding of the full range of programs and services available to all Highmark members.

To view the guide, go to the PRC, select EDUCATION/MANUALS, and then click Reference Guide Of Highmark Member Programs.

We encourage you to review this guide to help identify Highmark members who can benefit from the programs and services we offer. See the article in this month’s Provider News for more information about the Reference Guide .