Before you start
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. 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.
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.