Updates to Locum Tenens Policy and Credentialing Rights Information

Highmark recently announced the following important credentialing policy updates for our network practitioners:

Change to locum tenens policy coming 8/22/17

Beginning Tuesday, Aug. 22, 2017, Highmark will update its locum tenens policy to shorten the credentialing timeframe for physicians who practice temporarily in place of network physicians. As of Aug. 22, locum tenens physicians who practice as substitutes for at least 60 days must complete initial credentialing with Highmark. (The current practice limit is six months before credentialing is required.) 

Chapters 2.2, 2.3, and 2.4 of the Highmark Blue Shield Office Manual will be updated to reflect this change. The change won’t be noted in the manual until Aug. 22.

For information on other locum tenens provider requirements, see the Highmark Blue Shield Office Manual.

Credentialing rights information updated in manual

Highmark recently updated the Practitioner Credentialing Rights section in the Highmark Blue Shield Office Manual. This section is found in Chapter 2, Unit 2, of the manual.

The updates are noted in blue italics on pages 14 through 16 and address the following topics:

• The practitioner’s right to review certain information submitted about him/her from outside sources during the credentialing process
• Notification of discrepancy between practitioner- and source-submitted information
• The right to correct any erroneous information
• The right to be informed of his/her credentialing status
• Communication regarding availability of practitioner credentialing rights information

Consult the Highmark Blue Shield Office Manual for complete credentialing information.