Provider Information Management Forms

Provider Information Management forms are used to maintain provider accounts as well as begin the process to join Highmark's networks for new practitioners and offices. Practice information updates can be made with many of the forms below. Please carefully read and follow the instructions contained within the individual form for submission. 

Highmark no longer requires a copy of the Medicare Welcome Letter for proof of Medicare eligibility. 

Electronic Forms

Electronic Forms are submitted directly to Highmark via this website.  You may need to upload documenation/provide additonal research during parts of this form.  Please feel free to take the time to research these items and input the responses as the form will not time out.  

Provider Information Management Documents

 

Last updated on 7/2/2019

 

To Top