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Highmark bcbs pa appeal form

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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 for professional credentialing. Electronic Forms are submitted directly to Highmark via this website. Please feel free to take the time to research these items and input the responses as the form will not time out. This form has been created for in-network provider use in order to comply with the No Surprises Act that was signed into law in December Changes to these elements will not be accepted via any other electronic form.

Contact Us. Provider Directory. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania.

Quick Links: Manuals. Highmark Provider Manual. Medical Policy Medical Policy. Medical Policies. Medicare Advantage Medical Policies. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania.

Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Quick Links: Manuals. Highmark Provider Manual. Medical Policy Medical Policy.

Medical Policies. Medicare Advantage Medical Policies. Requiring Authorization. Pharmacy Policy Search. Message Center. Manuals Highmark Provider Manual. Provider Information Management Forms. Electronic Forms Electronic Forms are submitted directly to Highmark via this website.

Request for Assignment Account - Please use this form when you need to create a billing account for your practice. Addition Request to Existing Assignment Account — Please use this form when needing to update practitioners affiliation to existing assignment account information. Contract Upload Form Please only use this form to send Highmark a contract.

Other uploads will not be processed and not be returned. Please use this form to indicate your DEA status.