Organizational Initial Credentialing Set Up

Highmark continually seeks ways to make its network credentialing process easier for our providers. We are required by federal law and the American Accreditation HealthCare Commission to initially credential providers who participate in Highmark's preferred provider networks and in Highmark's Medicare Advantage network.

Skilled Nursing Facilities, Home Health Agencies, DME, Orthotic & Prosthetics, Laboratories and Specialty Pharmacies:

These specialties are currently closed to network enrollment. Highmark performs outreach in the provider community when such services are determined to be a need. While closed network applicants are rarely considered, we do provide an option for special consideration. This process occurs before credentialing can begin.

Interested providers can complete the Special Consideration Questionnaire, which will be reviewed by the Contracting Department.

Attached please find the following documents to help you start the credentialing process:

Last updated on 3/21/2024 11:18:05 AM


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