Facility/Ancillary (Organizational) Initial Credentialing Set Up

Highmark continually seeks ways to make its network credentialing process easier for our providers. We are required by federal law and the American Accreditation HealthCare Commission to initially credential providers who participate in Highmark's preferred provider networks and in Highmark's Medicare Advantage network.

Please use the following documents to help you start the credentialing process:

 

Skilled Nursing Facilities, Home Health Agencies, DME, Orthotic & Prosthetics, Laboratories and Specialty Pharmacies

These specialties are currently closed to network enrollment. Highmark performs outreach in the provider community when such services are determined to be a need. While closed network applicants are rarely considered, we do provide an option for special consideration. This process occurs before credentialing can begin.

Interested providers can complete the Special Consideration Questionnaire, which will be reviewed by the Contracting Department.

 

Behavioral Health Providers

For help identifying Behavioral Health Organizational Providers, read the Highmark Provider Manual Chapter 4, Unit 2: Behavioral Health Providers, section 4.2 Levels of Care.

Please use the following to help you start the credentialing process:

  • Behavioral Health Application For Organizational Providers - This application is to be used by organizational providers only. Professional providers should select CREDENTIALING in the left-hand menu, click Credentialing, and then go to the PROFESSIONAL PROVIDERS – CREDENTIALING section of that page.
Last updated on 1/2/2024 3:00:56 PM

 

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