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We are pleased to announce that the new Highmark Provider Manual is now available!
We have consolidated the information from the Highmark Blue Shield Office Manual and the Highmark Facility Manual into one manual to serve as the primary online resource for all providers — professional, facility, and ancillary — in all of our service areas in Pennsylvania, Delaware, and West Virginia. Although the information is the same, we’ve organized it in a way that will help you find the information you need more easily.
The Highmark Provider Manual is available under Education/Manuals on the Provider Resource Center (PRC). It can also be accessed quickly by selecting Manuals on the dark gray Quicklinks Bar at the top of the PRC homepage.
The Highmark Provider Manual is comprised of six chapters based on key categories of content: General Information, Product Information, Provider Network Participation, Provider Responsibilities and Guidelines, Care and Quality Management, and Billing and Payment.
Unit titles identify if the unit is specific to professional or facility providers or, in some cases, a particular provider type (for example, Chapter 4.4: Ancillary Providers). Also, look for the icon on the first page of each unit to identify whether the unit is intended for Professional Providers, Facility Providers, or All Provider Types.
Along with our traditional chapter/unit format, we’ve also kept other features from the former manuals that can be accessed from Additional Resources at the bottom of the manual’s home page.
You can still access all tip sheets from throughout the manual in one location — the Tip Sheet Index. And all of the manual’s units are available as a single PDF document that lets you search the entire manual by keyword if you’re not able to determine which unit contains the information you’re seeking.
Also in this location are the archived versions of the former professional and facility manuals for historical reference, if needed.
As in the previous manuals, blue italic text will still be used to identify new or updated information. The Why blue italics? icon will be placed wherever there are blue italics.
We’ve added a new feature, the Quick Reference, at the top of the manual’s homepage. This is a one-page reference for the Highmark phone numbers you need the most — the Provider Service Center and Clinical Services. If you need another phone number, you’ll find a link on the document that will take you to the manual unit that contains additional contact information.
We’ve also created a Quick Reference icon that you’ll see throughout the manual to provide easy access to these important phone numbers from within the manual.
As always, we welcome your feedback so that we can make the manual as helpful as possible. If you would like to comment on or make suggestions for additional improvements to the Highmark Provider Manual, please email your comments to HPMeditor@highmark.com.
If you haven’t signed up for e-Subscribe yet, be sure to do so to receive our end-of-the-month “Highmark Provider Manual Updates” emails describing all updates and additions to the manual during the month. You’ll also receive other information by signing up for e-Subscribe — Provider News and Medical Policy Update newsletters and the In Case You Missed It notifications telling you about important messages you may have missed.
To subscribe, select Newsletters/Notices from the main menu on the PRC, and then E-Subscribe For Publications And Notifications.
