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Highmark Frequently Used Contact Information

Highmark Frequently Used Contact Information OASIS Eligibility, benefits and status of claims: call 1-800-462-7474, or in the Harrisburg area, 1-717-302-5125 on your ...

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Highmark Frequently Used Contact Information Authorizations Western Region Only: Medical/Surgical or Home Health: 1-800-248-4180, option 1 Behavioral Health Services: 1-800-628-0816, option 3 Healthcare Management Services via Provider Line: 1-800-547-3627, option 2 Central, Eastern, and Northeastern Region Only: Acute Care Facilities and Ancillary Providers: 1-866-731-8080, option 1 Professional Providers: 1-866-731-8080, option 2 BlueCard Eligibility To verify eligibility for BlueCard members, please use NaviNet or call 1-800-676-BLUE. Claim Inquiries for Non-NaviNet Enabled Providers Only those providers who do not have Highmark-hosted NaviNet, or who have non-routine inquiries that require analysis and/or research may contact the Provider Service Center at the following numbers: Western Region Medicare Advantage HMO claims: 1-866-517-8585 Western Region: 1-800-547-3627, option 2 Central Region: 1-866-731-8080 Western & Central Region Medicare Advantage PPO Claims: 1-866-588-6967 Eastern Region: 1-866-975-7290 Northeastern Region (Traditional Participating Providers): 1-888-827-7117 Northeastern Region BlueCare PPO (formerly AccessCare II):1-866-262-5635 Continued on next page What Region Am I? What Region Am I? Highmark Frequently Used Contact Information Coordination Of Benefits If both insurance companies make payments on a claim and the combined payments exceed your charge, notify Highmark Blue Shield s or Blue Cross of Northeastern s Customer Service department at the phone numbers listed below. The Customer Service Department will investigate and advise if a refund is requested. Central and Eastern PA Regions 1-866-731-8080 Northeastern PA Region Blue Cross of Northeastern PA BlueCare Traditional: 1-800-827-7117 BlueCare PPO: 1-866-262-5635 Western PA Region 1-866-763-3224, Option 1 Electronic Data Interchange (EDI) If you wish to begin to submit claims electronically, you may contact the EDI Operations support line at 1-800-992-0246 to speak with a representative. InfoFax Claims status and enrollment information: 1-800-891-1856 InfoFax Helpline: 1-800-985-2032 Medicare Medicare Part A Provider Inquiries: 1-800-488-0545 Medicare Part B Provider Inquiries: 1-800-488-0548 FreedomBlue Provider Service Center: 1-866-588-6967 For a complete list of Medicare Part A and Part B customer service lines, please visit NaviNet To learn more about NaviNet or to become a NaviNet enabled office, please call the Provider Service Center at: Western Region: 1-800-547-3627, option 2. Central Region: 1-800-345-3805, option 3. Hours are from 9:00 to 4:30 , Monday through Friday. What Region Am I? Highmark Frequently Used Contact Information OASIS Eligibility, benefits and status of claims: call 1-800-462-7474, or in the Harrisburg area, 1-717-302-5125 on your touch-tone telephone. Precertification Inquiries In the Western Region Only, please call: Healthcare Management Services via the Provider Line at 1-800-547-3627, Option 2 In the Central Region Only, please call: Healthcare Management Services at 1-866-731-8080 In Northeastern Pennsylvania Only, please call: Blue Cross of Northeastern Pennsylvania at 1-800-638-0505 In Eastern Pennsylvania Only, please call: Independence Blue Cross at 1-800-862-3648 Provider Information Management Requests to change data about a practice, , address, specialty, etc., must be in writing. In the Western, Central and Eastern Region: Fax written requests to 1-800-236-8641 In the Northeastern PA Region: Fax written requests to 570-200-6880. To follow-up on a requested change to practice information: In the Western, Central and Eastern PA Regions, please call 1-866-763-3224. In the Northeastern PA Region, please call 1-800-451-4447 To submit information to credential a provider for one of Highmark Blue Shield s networks: In the Western, Central and Eastern PA Regions: fax documents to 1-800-236-5907 In the Northeastern PA Region: fax documents to 570-200-6890 Highmark-hosted NaviNet-enabled providers can update addresses, office hours, telephone numbers and other data via the NaviNet system. What Region Am I?What Region Am I? Highmark Frequently Used Contact Information, Continued Special Investigations Unit (SIU) The Highmark Fraud and Abuse Hotline telephone number is: 1-800-438-2478. 1099 Misc For Central, Eastern, and Western Region Providers: If you have any questions about form 1099-Misc issues, please call 1-866-425-8275. You can also e-mail For Northeastern Region Providers: For providers located within the 13 counties of Northeastern Pennsylvania, (Bradford, Carbon, Clinton, Lackawanna, Luzerne, Lycoming, Monroe, Pike, Sullivan, Susquehanna, Tioga, Wayne and Wyoming), please call 1-800-451-4447. What Region Am I?

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