Staying Up to Date with the Highmark Provider Manual
Ensure you are regularly reviewing the Highmark Provider Manual for our most recent guidance on:
- Participation Rules
- Credentialing/Recredentialing Criteria and Procedures
- Medical Record Criteria
- Requirements for 24/7 Coverage
Some recent noteworthy additions include:
- Contact Information Tip Sheets updated
- Types of Professional Providers Credentialed updated in Chapter 3, Unit 2
- General Credentialing Criteria for Physician Assistants added to Chapter 3, Unit 2
- Right Start information replaced with High-Risk Maternity Program
- Medicare Advantage added for New York regions
- Provider Service Phone Number added to the infertility benefit in Chapter 4, Unit 1
- Clinical Services/Behavioral Health hours updated
- Making a Determination of Coverage based on Medical Necessity for New York regions was added to Chapter 5, Unit 4
Provider News, Issue 6, 2022 | © 2022 Highmark Blue Shield of Northeastern New York