Do you treat Children’s Health Insurance Program (CHIP) patients and/or provide services to them?
If so, you must have an active Provider Reimbursement and Operations Management Information System Identification (PROMISe™ ID) on file with the Pennsylvania Department of Human Services and Highmark. The information you have on file must include your provider type and each service location where you see CHIP enrollees.
Highmark is required to deny claims if we are unable to match your National Provider Identifier (NPI) reported on the claim to a PROMISe enrollment record for the service location where the services were performed.
In addition, you are required to select a PROMISe ID-enrolled provider when submitting any authorization requests for referrals in NaviNet®.