Skip to main content

​
Before you start

Before you submit: Make sure the practice EIN/TIN, each clinician’s individual rendering NPI, the practice or claim-service address, and other practice details you give this plan exactly match the information in Thrizer. Use this guide when Highmark is a required Local / Host Plan for your practice or claim-service location. Your practice coordinates registration and any required clinician records so the payer can process affected claims. Registration is separate from joining a network and does not guarantee reimbursement. Highmark serves Delaware and West Virginia statewide, parts of New York, and several Pennsylvania regions. In New York, its service-area map shows western and northeastern counties. The northeastern area overlaps counties in Anthem’s commercial operating area; where both serve your location, plan for separate registrations. Check the applicable Highmark company before submitting; being in one of these states does not establish which first-time route your practice needs. Not sure which plan applies? First identify your required Local / Host Plan. Highmark’s provider manual documents a nonparticipating registration route using rendering and billing NPIs. Confirm the applicable Highmark company and service area before sending a request; do not assume registration with one company covers every Highmark plan.

​
Registration steps

1

Open the nonparticipating instructions

Open Highmark’s provider manual, Chapter 3, Unit 1 and find 3.1 How to Register with Highmark. This is separate from How to Become a Participating Provider.
2

Confirm the packet for your practice

Ask your applicable Highmark plan to confirm that this route applies to your service area and which supporting documents and clinician affiliations it needs.You can ask: “We need nonparticipating provider records for claims where the member receives reimbursement. What should our practice send, and how do we associate our clinicians?”
3

Send the required NPIs and confirmed documents

Include the practice’s actual billing NPI and the applicable clinicians’ individual rendering NPIs. The manual gives this mailing destination:Highmark Blue Shield
Provider Information Management
P.O. Box 898842
Camp Hill, PA 17089-8842Follow any applicable instructions Highmark confirms for your request. If records already exist, ask about updates or affiliations rather than creating duplicates.
4

Confirm that the records are active

Keep a copy of your request. Ask Highmark to confirm that the practice record and required clinician associations are active; mailing the request alone does not complete registration.

​
Do not substitute an assignment-account request

Highmark’s separate Request for New Billing Practice (Assignment Account) form concerns assigning providers’ payment rights to an entity under a TIN. Do not assume it replaces the nonparticipating registration instructions above. For BCBS claims through Thrizer, the client pays the appointment price plus any applicable practice OON billing service charge and receives any insurance reimbursement. See Pricing overview for the applicable pricing period and fees. If Highmark asks for an assignment account, confirm the appropriate member-reimbursement process before proceeding.

​
What happens next

Once each required plan confirms registration and the required clinician associations are active, notify Thrizer support and review what happens next. For associate, pre-licensed, or supervised clinicians, confirm payer recognition separately and review Thrizer’s supported claim structure.