Timely Access to Support: Coding for Optimal Care

Highmark is committed to connecting our members with chronic conditions to meaningful support. Our Clinical Support Programs provide personalized support and guidance to help your patients manage their chronic conditions between office visits.

For example, a patient with type 1 or type 2 diabetes will be eligible for our virtual Diabetes Management Program and a Highmark member diagnosed with congestive heart failure (CHF) and/or chronic obstructive pulmonary disease (COPD) can be enrolled in CHF and COPD Management powered by Vida.

Accurate coding is crucial to ensure that your patients gain access to these valuable programs. Their eligibility is based on the diagnosis codes you send us through claims. Please help us offer the right programs to Highmark members who need them by:

  • Reviewing patient records, and accurately documenting and coding diagnoses and conditions
  • Staying up to date on the latest coding guidelines
  • Ensuring your patients are aware of their diagnoses

By working together, we can make sure that your patients have access to the resources they need and support your office by helping your patients stay healthy and stick to their care plans.

Resources

Coding guidance can be found on the Provider Resource Center (PRC) . From the left menu, you can select the following resources:

  • EDUCATION/MANUALS > Coding Education/HCC University
  • EDUCATION/MANUALS > Population Health University > Coding Education

To learn more about Highmark’s Clinical Support Programs, including patient eligibility information, please go to:

  • EDUCATION/MANUALS > Clinical Support Programs


 

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