WebPennsylvania. Highmark Inc. or certain of its affiliated Blue companies also serve Blue Cross Blue Shield members in 29 counties in western Pennsylvania, 13 counties in northeastern Pennsylvania, the state of West Virginia plus Washington County, Ohieo, th state of Delaware and 8 counties in western New York. All references to Highmark in this ... WebApr 6, 2024 · Authorization Forms. Bariatric Surgery Precertification Worksheet. Behavioral Health (Outpatient - ABA) Service Authorization Request. Designation of Authorized …
Highmark: Comprehensive Cardiology and Radiology CPT …
WebCPT® Code Description Prior Authorization Required 3DI: 76376 3D Rendering W/O Postprocessing Yes: 3DI 76377 3D Rendering W Postprocessing: Yes BMRI: 77046 Magnetic resonance imaging, breast, without contrast material; unilateral Yes: BMRI 77047 Magnetic resonance imaging, breast, without contrast material; bilateral: Yes BMRI: 77048 Magnetic … WebJul 1, 2024 · Highmark Health Options is an independent licensee of the Blue Cross Blue Shield Association, an association of independent Blue Cross Blue Shield Plans. 5 Ear Molds Services Codes Prior Authorization Requirement Ear mold/insert, not disposable, any type. V5264 If the cost is greater than $500, prior authorizations are required. family id certificate
Provider Resource Center
WebAuthorization is required for: Cardiology and radiology services Services performed in conjunction with an inpatient stay, 23-hour observation, or emergency room visit are not subject to prior authorization requirements. To request a prior authorization: Log in at www.evicore.com or call eviCore healthcare’s call center at 888-564-5492 ... WebPrior Authorization Soon Required For SOC Infusion Drugs Included In FEP. 2/28/2024. Authorizations For Home Health, Hospice & Outpatient Therapy Routed to New UM Tool. ... Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of ... WebTHIS REQUEST FOR AUTHORIZATION REVIEW CANNOT BE PROCESSED WITHOUT SUPPORTING CLINICAL DOCUMENTATION AND/ OR INFORMATION – NO EXCEPTIONS. Requests missing clinical information will be returned to the requesting provider, delaying the review process. Please fax completed form to Clinical Services: 888.236.6321 … family id braintree high school