Highmark Health Emergency Billing Guidelines

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Highmark Updates Tied to End of Public Health Emergency

(1 days ago) WebOn January 30, 2023, the federal government announced that the COVID-19 public health emergency (PHE) would expire on May 11, 2023. In response to the COVID-19 pandemic and pandemic-related laws, Highmark implemented many policies and flexibilities …

https://content.highmarkprc.com/Files/NewsletterNotices/SpecialBulletins/sb-post-phe-provider-communication.pdf

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2021 Provider Manual - Highmark Health Options

(7 days ago) Web7.2 Highmark Health Options Specific Billing • Specialty/Fee -For Service Providers 253 • Highmark Health Options Members with Medicare 254 • Subrogation 256 • Early and …

https://www.highmarkhealthoptions.com/content/dam/digital-marketing/en/highmark/highmarkhealthoptions/providers/provider-resources/2021_06042021_Provider_Manual_VF.pdf

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Public Health Emergency Ending: Updates for Providers

(5 days ago) WebOn January 30, 2023, the federal government announced that the COVID-19 public health emergency (PHE) will expire on May 11, 2023.. In response to the COVID-19 pandemic …

https://hnenybs.highmarkprc.com/pnews/pn-4-2023/public_health_emergency_ending_updates_for_providers.html

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Reimbursement Policy - Highmark Health Options

(1 days ago) WebHighmark Health Options is an independent licensee of the Blue Cross Blue Shield Association, 1 A. Emergent Criteria – Emergency Department criteria requires the …

https://www.highmarkhealthoptions.com/content/dam/digital-marketing/en/highmark/highmarkhealthoptions/providers/medical-payment-policies/PractitionerAndFacilityEmergencyDepartmentReimbursement-HHO-DE-RP-1126.pdf

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Clinical Practice Guidelines - Highmark Health Options

(3 days ago) WebClinical Practice Guidelines. Clinical Practice Guidelines can be used to help direct care based on best available evidence based practices in order to reduce inappropriate …

https://www.highmarkhealthoptions.com/providers/guidelines-resources.html

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Highmark Reimbursement Policy Bulletin

(1 days ago) WebHighmark Reimbursement Policy Bulletin Bulletin Number: Subject: RP-057 • Emergency Department codes (99281 - 99285) • Nursing Facility service codes (99304 - …

https://content.highmarkprc.com/Files/ClaimsPaymentReimb/ReimbPolicies/rp-057.pdf

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New and Updated Reimbursement Policies

(9 days ago) WebUPCOMING. IMPORTANT: With the public health emergency (PHE) coming to an end, the following reimbursement policies (RPs) will have Telehealth and Virtual Health …

https://hbcbs.highmarkprc.com/pnews/pn-4-2023/new_and_updated_reimbursement_policies.html

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EE-0222-2022 FQHC Billing Guidelines 042522 - Highmark …

(5 days ago) WebProviders will be reimbursed for one encounter code per day, with the exception of a medical and a mental health encounter billed on the same day on a separate claim form. If you …

https://www.highmarkhealthoptions.com/content/dam/digital-marketing/en/highmark/highmarkhealthoptions/providers/providernews/providerannouncements/hho-fqhc-billing-guidelines-042522.pdf

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Public Health Emergency Highmark

(5 days ago) WebFederal Public Health Emergency FAQ. The Federal Public Health Emergency ends on May 11, 2023. On January 30, 2023, the Biden administration …

https://newtenv3.highmark.com/resources/answers/faq/public-health-emergency

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CORONAVIRUS (COVID-19) TELEHEALTH SERVICES FAQS

(7 days ago) WebTo broaden access to telehealth services during the COVID-19 public health emergency, Highmark Health Options is temporarily waiving the CMS and state-based originating …

https://www.highmarkhealthoptions.com/content/dam/digital-marketing/en/highmark/highmarkhealthoptions/providers/COVID-19-provider-resources/COVID-19_TelehealthFAQs.pdf

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New and Updated Reimbursement Policies

(7 days ago) WebThe American Medical Association has released new codes 91312, 91313, 0124 A, 0134 A, which are retroactively effective August 31, 2022, and are being added to the policy. …

https://hbs.highmarkprc.com/pnews/pn-5-2022/new_and_updated_reimbursement_policies.html

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Provider Resource Center

(7 days ago) WebEach reimbursement policy includes information pertaining to all Highmark markets as indicated in the header, with state specific variations indicated within the policy bulletin. …

https://hbs.highmarkprc.com/Claims-Payment-Reimbursement/Reimbursement-Policy

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New and Updated Reimbursement Policies

(9 days ago) WebPopulation Health University Emergency Department Utilization Module Now Available; Mental Health Awareness Month; Highmark Seeking Members for the Medical Review …

https://hbcbs.highmarkprc.com/pnews/pn-2-2022/new_and_updated_reimbursement_policies.html

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No Surprises Act - Highmark

(1 days ago) WebNo Surprises Act. For consumers who get coverage through their employer (including a federal, state, or local government), through the Health Insurance Marketplace ® or …

https://www.highmark.com/no-surprises-act

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Highmark Reimbursement Policy Bulletin

(1 days ago) WebPage 4 of 11 *Note: If mandated by your OPPS payment methodology for reporting clinic visits. Note: Revenue code 780 should be used when billing Q3014. …

https://content.highmarkprc.com/Files/ClaimsPaymentReimb/ReimbPolicies/rp-046.pdf

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New and Updated Reimbursement Policies

(7 days ago) WebOnce redirected to the Provider Resource Center, choose CLAIMS, PAYMENT & REIMBURSEMENT from the left menu then Reimbursement Policy. This policy is being …

https://hbs.highmarkprc.com/pnews/pn-2-2023/new_and_updated_reimbursement_policies.html

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Emergency Department Room Claim Audits

(1 days ago) WebHighmark will review the diagnoses submitted as well as the services performed to determine the appropriate level of care for the visit on a scale of one (1) through five (5). …

https://hnenybs.highmarkprc.com/pnews/pn-2-2023/emergency_department_room_claim_audits.html

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Disclaimer - Highmark Health Options

(8 days ago) Web1 Disclaimer Highmark Health Options’ medical claims payment and prior-authorization policy is a reference resource regarding payment and coverage for the services …

https://www.highmarkhealthoptions.com/content/dam/digital-marketing/en/highmark/highmarkhealthoptions/providers/medical-payment-policies/Telemedicine_Policy_COVID19.pdf

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web EE-0177-2022 FQHC Billing Guidelines Fax Blast 030422

(1 days ago) WebHighmark Health Options is an independent licensee of the Blue Cross Blue Shield Association, an association of independent Blue Cross Blue Shield Plans. FQHC …

https://www.highmarkhealthoptions.com/content/dam/digital-marketing/en/highmark/highmarkhealthoptions/providers/providernews/providerannouncements/fqhc-billing-guidelines-032022.pdf

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New DME Fee Schedule, MCG Transition, and More

(1 days ago) WebNew DME Fee Schedule. Highmark Blue Cross Blue Shield West Virginia routinely reviews its fee schedule reimbursement rates and adjusts, as necessary, to maintain appropriate …

https://hwvbcbs.highmarkprc.com/pnews/pn-2-2023/short_takes_DME_fee_MCG_more.html

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