To help ensure that outpatient physical medicine services (physical therapy, occupational therapy and manipulation services) provided to our members are consistent with nationally recognized clinical guidelines, Highmark West Virginia has contracted with WholeHealth Networks, Inc. (WHN), a subsidiary of Tivity Health Support, LLC., to administer a registration process for physical medicine services as well as to provide medical necessity review and authorization, where applicable, for these services, effective with dates of service of Sept. 1, 2012, and beyond.
This page will serve as a reference source for providers to learn about the launch and implementation of this program. Check back often as additional information will be added on an ongoing basis.
Learn More About the Physical Medicine Management Program
- Medical Doctors, Doctors of Osteopathic Medicine, Doctors of Chiropractic, CRNPs, Physical Therapists and Occupational Therapists
- Hospital and Skilled Nursing Facilities
- Physical Medicine Management Program – Important Updates
- Highmark West Virginia's Physical Medicine Management Program began Sept. 1, 2012. As you begin to follow the program, we are committed to providing ongoing updates and the information you need during the Program's implementation. Read important updates and check back often for the most current information
Please continue to look for future communications from us on this topic, and check the Plan Central page of NaviNet, Today’s Messages on the Provider Resource Center and upcoming issues of Provider News for additional tools and information to assist you in the program's authorization process.
The following documents/forms include information that supports the Physical Medicine Management Program; the purpose of each is fully explained in the Administrative Guide above.
Outcome Assessment Tool
Reconsiderations and Appeals
The training module below includes audio. Please ensure that your speakers are adjusted accordingly.
Advisory Committee Meeting Minutes
- March 22, 2016
- August 11, 2015
- May 12, 2015
- February 3, 2015
- November 11, 2014
- August 26, 2014
- May 30, 2014
- February 11, 2014
- November 12, 2013
- May 14, 2013
- February 12, 2013
- November 13, 2012
Last updated on 6/28/2019