Please use these reference materials to access the codes and guides you are looking for.
Governing Policy and Procedures
Beginning Jan. 1, 2016, providers will be governed by two sets of Policies and Procedures as they relate to treating patients:
Please Note: Effective Jan. 1, 2016:
As always, it is essential that you review each patient’s member ID card and compare it to that member’s current Eligibility and Benefits (E&B) information on NaviNet to ensure the correct insurer’s policies/procedures apply.
To check E&B information for patients with a FPH/FPLIC alpha prefix, please utilize NEPA/FPH NaviNet, and for checking E&B information on patients with a Highmark BCBS alpha prefix, please utilize Highmark NaviNet.
Providers need to continue to check all future issues of the Provider Bulletin for updated alpha prefix information, including the complete alpha prefix chart once it is available
Select the provider form you wish to complete from the menu. These forms are to be used ONLY by physicians and/or facilities when requesting authorization for services.