Staying Up to Date With the Highmark Provider Manual

Ensure you are regularly reviewing the Highmark Provider Manual for our most recent guidance on:

  • Participation Rules
  • Credentialing/Recredentialing Criteria and Procedures
  • Medical Record Criteria
  • Requirements for 24/7 Coverage

Some recent noteworthy changes include:

  • New York Provider Service phone numbers were consolidated to one phone number (800-950-0051) throughout the manual.
  • InterQual information was removed, and MCG Clinical Guidelines were added throughout the manual.