Provider Orientation

WELCOME TO HIGHMARK WEST VIRGINIA!

If you are a newly contracted provider, or a new employee of a network provider's office or facility, we would like to introduce you to the many resources we make available to help you in your interactions with Highmark West Virginia and our members. 

Let's begin with some background on Highmark to help you get to know us:

And now to get started working with Highmark, here is what you need to know: 

And finally, please be sure to report any changes to us regarding your office, facility, or participating care providers! Visit our Provider Data Accuracy Compliance page for requirements for accurate, up-to-date provider data in our Provider Directory and instructions on how to make any changes to your information on file with us. 

The Provider File Management Guide is included there, too, to assist professional providers in reporting changes via NaviNet.  And a link to the Address/Phone Number Change Form for Facility & Ancillary Providers is provided on the page for our participating facilities and ancillary providers. 

Thank you for your support and for providing high-quality care to our members, your patients. Welcome to Highmark West Virginia - we look forward to working with you!


Note: If you are not yet contracted with Highmark West Virginia and are interested in participating in our provider networks, you can start by selecting CREDENTIALING from the main menu on the left, and then choosing the appropriate option based on your provider type. 

You can also find participation information in Chapter 3 of the Highmark Provider Manual . To access the manual, select MANUALS on the Quicklinks Bar located at the top of the Provider Resource Center. Contact Provider Services in your service area with any questions. 


Note: To participate in the Highmark West Virginia Family Health Plan, it is a federal requirement, released by the Centers for Medicaid and Medicare Services (CMS), that providers enroll through DXC Technologies (f.k.a. Molina).  All necessary information must be submitted in order for their enrollment application to be processed making them eligible to serve MCO Medicaid members.

To enroll, please contact the WV Provider Enrollment Department at 888.483.0793 or by email at WVproviderenrollment@molinahealthcare.com. You may also email questions to www.wvmmis.com.


Last updated on 2/20/2019

 

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