WebHighmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Web3. Fax the completed form and all clinical documentation to 888-236-6321, Or mail the completed form to: PAPHM-043B Clinical Services 120 Fifth Avenue Pittsburgh, PA 15222 For a complete list of services requiring authorization, please access the Authorization Requirements page on the Highmark Provider Resource Center under
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WebComplete ALL information on the form. NOTE: The prescribing physician (PCP or Specialist) should, in most cases, complete the form. 3. Please provide the physician address as it is … WebThe RRS pre-screening will either approve or pend your authorization request. If additional information is required, you will receive a fax request indicating the specific clinical information to submit for utilization review. Use the request form, which is bar-coded for this specific patient, as a cover sheet when faxing clinical inception conference
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WebHighmark 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 … WebHighmark's mission is to be the leading health and wellness company in the communities we serve. Our vision is to ensure that all members of the community have access to affordable Webstate of Delaware and 8 counties in western New York. All references to Highmark in this document are references to Highmark Inc. d/b/a Highmark Blue Shield and/or to one or more of its affiliated Blue companies. Updated 2.2 8.2024 . Highmark. Blue Shield . Clinical Services Utilization Management . Authorization Request Form ina wedge salad with blue cheese dressing