Highmark security blue providers

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Log In to the Shopping Cart. Need to Make a Payment? Access Your Payment Options. Returning Shopper. Make a Payment. Pay Now. As you transition to Medicare, we hope you'll Stay with Blue and get Medicare coverage from a company you trust. Blue Access for Members SM is a powerful tool for managing all your health plan benefits.

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Sign up for the LifeTimes newsletter to get new articles delivered to your inbox every month. Blue Cross and Blue Shield of Texas is a statewide, customer-owned health insurer. We believe Texas consumers and employers deserve the best of both worlds: access to affordable, quality health care and top-notch service from a company that focuses solely on customers, not shareholders.

Customer value is our cornerstone. For more than 90 years, we have forged alliances with local nonprofit organizations to show our commitment to help build healthy communities. We want to continue to foster health improvements through these alliances so that together we can offer sustainable, measurable programs that strengthen and enrich our communities.

Welcome Employers Producers Providers. Pharmacy Find a Pharmacy Pharmacy Programs. Whether managing your claims or making informed health care decisions; Highmark can help with easy-to-use online tools. Need a hand? Call Member Service. Give Member Service a call to find doctors, get details on your health plan, and help you understand your Explanations of Benefits.

Use our Provider Search Tool to search for in-network doctors, hospitals, urgent care centers, freestanding diagnostic centers, and more. You can also take our Doctor Match Quiz to get connected with a doctor who suits your personal style, find top-quality specialty care, compare hospitals, and, for those who may be traveling, search for in-network doctors across the country and around the world.

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The authorization is typically obtained by the ordering provider. Some authorization requirements vary by member contract. This information should not be relied on as authorization for health care services and is not a guarantee of payment.

Benefit plans vary widely and are subject to change based on the contract effective dates. The provider is responsible for verification of member eligibility and covered benefits. Effective dates are subject to change. Highmark will provide written notice when codes are added to the list; deletions are announced via online publication.

Examples of services that may require authorization include the following. This is not an all-inclusive list. Benefits can vary; always confirm member coverage. The online portal is designed to facilitate the processing of authorization requests in a timely, efficient manner. If you are a Highmark network provider and have not signed up for NaviNet, learn how to do so here.

Highmark recently launched a utilization management tool, Predictal, that allows offices to submit, update, and inquire on medical inpatient authorization requests.

Fax: If you are unable to use NaviNet, you may also fax your authorization requests to one of the following departments. The associated preauthorization forms can be found here. Telephone: For inquiries that cannot be handled via NaviNet, call the appropriate Clinical Services number , which can be found here.

Highmark contracts with WholeHealth Networks, Inc. Additional information about the programs and links to prior authorization codes are available under Care Management Programs in the left website menu. Authorization number not appearing, unable to locate member, questions about clinical criteria screen. Contact Us. Provider Directory. Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

This website uses cookies. It uses cookies to ensure that it gives you the best experience on our website. If you continue without agreeing to the cookie conditions, we'll assume that you are happy to receive all cookies on this website. Read more. Covid Vaccination Information Effective November 1, , Highmark Health and its affiliates are requiring all new hires beginning employment to submit proof of full vaccination with one of the three authorized COVID vaccines.

File Maintenance Analysis. Routinely contact external sources such as the Provider offices, state licensing agencies and provider reps to collect or clarify information or documentation, which in turn must be reviewed and evaluated against the established guidelines Ensure the file meets all regulations prior to updating the provider file 3.

Maintain and update internally required data elements which include but are not limited to: Assigned Blue Shield provider numbers National Provider Identifier NPI CMS required provider identifiers for compliance with corporate and federal contracts.

This individual will be also responsible to educate providers for obtaining and updating provider identifiers. Other duties as assigned or requested. Introduce yourself and we'll get in touch monthly to share career insights and company news.