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Medical Protocol Updates Available Online – July 2022

Date:
July 26, 2022

HIGHMARK SYSTEMS

Highmark’s monthly Medical Policy Update Newsletter will be available online on or before July 25. These changes may impact your patients who have moved onto Highmark’s system. Policy updates described in the newsletter will be effective October 24, 2022 and can be reviewed by clicking the link below:

All medical policies for Highmark system patients can be reviewed by clicking on the link below:

Recent Articles

  • Provider Resource Center to Replace Legacy Provider Website on February 1, 2023
    Beginning on February 1, 2023, we will be redirecting those visiting our legacy provider website (bsneny.com/provider) to the Highmark Provider Resource Center (PRC). The timing of this transition will occur after all Highmark BSNENY patients have been moved onto Highmark’s system in January 2023. In this article, you can learn more about this change and how to access important resources on the PRC.
  • New Phone Self-Service Tools
    To help reduce Provider Service call wait times, we’ve introduced new self-service phone tools. When you call Provider Service at 1-800-444-4552 or 1-800-950-0051, you will hear new voice prompts to help you access patient information, including claims status, eligibility, and benefits without speaking to a representative.
  • Virtual CME Opportunities
    As you consider how to complete required Continuing Medical Education (CME) before the end of the year, we are happy to offer some new CME opportunities. You can earn up to 6 CME credits online at no cost through Highmark’s Population Health University and Coding and Quality Knowledge College. In this article, you can register for online modules, as well as an October webinar.
  • 2023 Vatica Incentive Payment Changes
    Starting January 1, 2023, incentive payments for Vatica Annual Wellness Visits (AWV) will be paid directly from Vatica Health. Payments will be made monthly. This change creates a more streamlined process and eliminates the possibility of incentive payment discrepancies. Here, you can access updated billing grids and view coding guidance.
  • Utilization Management: Coverage and Denial Processes
    Understanding coverage and denial decisions and knowing the right steps to take after an authorization is denied will help your patient get the right care at the right time. This article provides further guidance on the appeal process after an authorization denial.

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