Select One
Behavioral Health
Doctors of Chiropractic
Durable Medical Equipment, Prosthetics, Orthotics, and Supplies
OB-GYN
Pediatrician
Physical Therapist/ Occupational Therapist
Primary Care Physician (PCP)
Other
N/A
Behavioral Health
Doctors of Chiropractic
Durable Medical Equipment, Prosthetics, Orthotics, and Supplies
OB-GYN
Pediatrician
Physical Therapist/ Occupational Therapist
Primary Care Physician (PCP)
Other
Select One
Alcohol/Drug Rehabilitation
Ambulatory Surgical Center
Comprehensive Outpatient Rehab (CORF)
Home Health Agency
Hospice
Hospital - Acute Care Facility
Medicare Advantage
Psychiatric
Rehabilitation
Renal Dialysis (ESRD)
Skilled Nursing Facility
Other
N/A
Alcohol/Drug Rehabilitation
Ambulatory Surgical Center
Comprehensive Outpatient Rehab (CORF)
Home Health Agency
Hospice
Hospital - Acute Care Facility
Medicare Advantage
Psychiatric
Rehabilitation
Renal Dialysis (ESRD)
Skilled Nursing Facility
Other
Quick Links:
Manuals
Highmark Facility Manual
WVFH Provider Manual
Highmark Blue Shield Office Manual
Medical Policy
Medical Policy
Medical Policies
Medicare Advantage Medical Policies
eSubscribe
Requiring Authorization
Pharmacy Policy Search
Message Center
Manuals
Highmark Facility Manual
WVFH Provider Manual
Highmark Blue Shield Office Manual
Medical Policy Search
Medical Policy Search
Medical Policies
Medicare Advantage Medical Policies
Pharmacy Policy Search
Requiring Authorization
eSUBSCRIBE
Site Map
Care Management Programs
AIS Home Visit Program
Care Management Programs
DIP Levels
Laboratory Management Program
Physical Medicine Management Program
Post-Acute Care Management for Medicare Advantage Members
Prior Authorization/Notification Information - Radiology Management Program
Privileging Application and Requirements - Radiology Management - WV
Radiation Safety Awareness - WV
Radiation Therapy Authorization Program
Radiology Management Program
Radiology Management Program Info
Radiology Management Program WV Clinical Guidelines
Claims, Payment & Reimbursement
Clinical Information Requirements
Documentation Guidelines for Evaluation and Management Services
Electronic Data Interchange (EDI) Services
Guidelines for HUD/HUE
HCPCS Information
List of Procedure Codes Requiring NDC Information
Medical Policy
Medical Policy Update Newsletter
PAP Device Program
Procedure Code Edits
Procedures/Service Requiring Prior Authorization
Reimbursement Policy
Credentialing
Professional Initial Credentialing Set Up
Initial Credentialing Request Form
Request Recredentialing
Check the Status of your Request
Credentialing Webinar
Accessibility Standards
Education/Manuals
A Key Area of Focus to Combat Childhood & Adult Obesity
Behavioral Health ACM Authorization Submission Manual
Behavioral Health Practice Resources
Childhood Obesity Physician Tool Kit
Chlamydia Testing in Young Women: Room for Improvement
Clinical Practice and Preventive Health Guidelines
Diabetic Information
Educational Materials
Free cultural competency training
Geriatric Resource Binder
Health Care Disparities: An Overview
Health Equity & Quality Services
Health Literacy: A Closer Look
Highmark Blue Shield Office Manual
Highmark Blue Shield Office Manual Appendix - WV
Highmark Blue Shield Office Manual Archive
Highmark Blue Shield Office Manual Glossary
Highmark Blue Shield Office Manual Tip Sheet Index
Highmark Facility Manual
Highmark Facility Manual Appendix - WV
Highmark Facility Manual Archive - WV
Highmark Facility Manual: Tip Sheet Index
Highmark Provider Manual Archive
HPV Vaccine and Cancer Prevention
Improving Blood Pressure Control
Medicare Advantage Member Evidence of Coverage Booklets
Office Site and Medical Record Evaluation Forms
Optimizing Treatment In The Patient With Rheumatoid Arthritis
PCP and OBGYN Practice Resources
Prevention 101 Awareness Posters
Provider Data Accuracy Compliance
Provider Documentation References
Provider File Management: NaviNet Guide
Provider Training
Quality Management Partners in Quality Tool Kit
SilverSneakers
What is Culturally Competent Health Care
WVFH Medicaid Primary Care Incentive Program
WVFH Provider Manual
Forms
Behavioral Health Forms
Certificate of Medical Necessity (CMN) for DME Providers
FEP Medical Health Forms
Miscellaneous Forms
Professional Initial Credentialing Set Up
Provider Application for Behavioral Health Providers
Provider Application for Facility and Ancillary Providers
Provider Information Management Forms
Inter-Plan Programs
Blue Distinction Centers For Specialty Care Program
BlueCard Information Center
Medical Policy and Pre-certification Pre-authorization Information for Out-of-Area Members
Medicare Advantage PFFS Search
Newsletters/Notices
Clinical Views
e-Subscribe for Publications and Notifications
Facility Bulletins (2014 & older)
Hot Topic Library
Hot Topic Library - 2014
Hot Topic Library - 2015
Hot Topic Library - 2016
Medical Policy Update Newsletter
Provider News
Special Bulletins & Mailings
Pharmacy Program/Formularies
About ID cards - Information for Pharmacists PA & WV
Diabetes Medications Dosing Guide
Formulary Information
List of Procedure Codes Requiring NDC Information
Medical Injectable Drug Program WV
Pharmaceutical Management (Clinical Management Programs) WV
Pharmacy Benefits Program WV
Pharmacy Information
Pharmacy Policies - SEARCH
Prescription Drug Prior Authorization - WV
Process for Requesting Drug Coverage from a Pharmaceutical Management Program
Program for Self-Administered Injectable or Oral Biotechnology Drugs
What is the Formulary?
Value-Based Reimbursement Programs
Adult BMI Assessment
All-Cause Readmissions: Medicare Advantage
Annual Wellness and Initial Preventative Physical Exam Rate
Breast-Cancer-Screening
Colorectal Cancer Screening
Comprehensive Diabetes Care: Eye Exam (retinal) Performed
Comprehensive Diabetes Care: HbA1c Control (<9%)
Comprehensive Diabetes Care: Medical Attention for Nephropathy
Disease-Modifying Anti-Rheumatic Drug Therapy for Rheumatoid Arthritis
High Risk Medications - MA Stars
Medicare Advantage Stars
Medicare Advantage Stars About - PA WV Both
Medication Adherence for Cholesterol (Statins)
Medication Adherence for Diabetes Medication
Medication Adherence for Hypertension: Renin Angiotensin System Antagonists (RASA)
Medication Reconciliation Post Discharge
Medication Therapy Management
Osteoporosis Management in Women who had a Fracture
Statin Therapy: Cardiovascular Disease
Statin Therapy: Diabetes
Value-Based Reimbursement Programs Overview
Other Resources
Highmark 2017: Important Product News
Highmark 2018: Important Product News
Highmark West Virginia PRC Home
Message Center - WV
Provider FAQ
Report Site Issues
Site Map
WV - Legal Information
To Top