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 changes occurred in the following chapters and units:
- Chapter 1, Unit 4: Highmark Member Information
- Chapter 2, Unit 6: The BlueCard Program
- Chapter 3, Unit 2: Professional Provider Credentialing
- Chapter 4, Unit 1: PCPs and Specialists
- Chapter 4, Unit 2: Behavioral Health Providers
- Chapter 4, Unit 7: Durable Medical Equipment and Prosthetics
- Chapter 5, Unit 1: Care Management Overview
- Chapter 5, Unit 3: Medicare Advantage Procedures
- Chapter 5, Unit 7: Value-Based Reimbursement Programs
- Chapter 5, Unit 6: Quality Management
- Chapter 6, Unit 8: Payment Review
To see the full list of recent changes, visit the Highmark Provider Manual Changes page.
Provider News, Issue 8, August 2024 | © 2024 Highmark Blue Shield