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 2: Online Resources & Contact Information
- Chapter 3, Unit 2: Professional Provider Credentialing
- Chapter 3, Unit 3: Professional Provider Guidelines
- Chapter 5, Unit 1: Care Management Overview
- Chapter 5, Unit 2: Authorizations
- Chapter 5, Unit 5: Denials, Adverse Benefit Determinations, Grievances, and Appeals
- Chapter 5, Unit 6: Quality Management
- Chapter 6, Unit 1: General Claim Submission Guidelines
To see the full list of recent changes, visit the Highmark Provider Manual Changes page.
Provider News, Issue 6, June 2024 | © 2024 Highmark Blue Cross Blue Shield