Highmark and WholeHealth Networks, Inc. (WHN), a subsidiary of Tivity Health Support, LLC., have been working together since 2012 to ensure Highmark members receive quality care that is aligned with evidence-based guidelines through Highmark’s Physical Medicine Management Program. WHN applies guidelines developed using nationally accepted standards and with input from actively practicing practitioners in their authorization and medical necessity review processes for physical therapy, occupational therapy, and chiropractic services.
Highmark provides numerous resources on the Provider Resource Center to help you understand and navigate the requirements of the program. This includes the Physical Medicine Management Program Administrative Guide (the Administrative Guide”), which details the program’s requirements and also provides step-by-step instructions for submitting registrations and authorization requests using NaviNet®.
To assist you in increasing your proficiency with the program, WHN offers you valuable tips for submitting your authorization requests and documenting your patients’ care. These helpful tips were recently provided in a Special eBulletin 
dated July 1, 2019. You will also find these tips for improving your experience with the program in the program’s Administrative Guide.
To access the Physical Medicine Management Program Administrative Guide and much more, select CARE MANAGEMENT PROGRAMS from the main menu on the Provider Resource Center, and then click on Physical Medicine Management Program.
Whole Health Networks (WHN) is an independent company that provides physical medicine benefit management services for Highmark.
