We're so glad you decided to join the Highmark Wholecare family.
As a provider, you have access to a wide variety of tools and resources designed to help you deliver better service.
If you haven't already done so, follow these simple steps to get the most out of your Highmark Wholecare partnership.
1. Join our network by completing this form. (To Be Updated with Join Network URL)
2. Download your provider manual.
3. Login to the provider portal.
4. Review the Quality Improvement Guidelines and Resources.
5. Review and download Medicare Assured and Medicaid Policies.
6. Check out the Provider Newsletter.
Tools and Resources
Highmark Wholecare participating providers have access to our Provider Authorization Portal. Simply access the portal by clicking here. The new Authorization Portal was integrated into the Highmark Wholecare platform that includes all of the functionality of the original and also includes features such as:
- Overall application optimization results in a faster and more robust experience.
- Modern design built for use on desktop, tablet, or mobile devices.
- Enhanced Authorization form workflows and functionality.
- More information and feedback available regarding submitted Authorizations.
- Advanced Authorization submission search functionality.
- Batch Claims lookup allows quick and full search criteria for completed claims.
- Other self-service features will include: Secure Messaging and Document Exchange.
Frequently Asked Questions
Centers for Medicare and Medicaid Services
As of July 1, 2001, the Health Care Financing Administration (HCFA) is now the Centers for Medicare & Medicaid Services (CMS).
Department of Health and Human Services
The Department Of Health And Human Services is the United States government's principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves.
National Institute of Health
NIH is the steward of medical and behavioral research for the Nation. Its mission is science in pursuit of fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to extend healthy life and reduce the burdens of illness and disability. The goals of the agency are as follows: 1) foster fundamental creative discoveries, innovative research strategies, and their applications as a basis to advance significantly the nation's capacity to protect and improve health; 2) develop, maintain, and renew scientific human and physical resources that will assure the Nation's capability to prevent disease; 3) expand the knowledge base in medical and associated sciences in order to enhance the Nation's economic well-being and ensure a continued high return on the public investment in research; and 4) exemplify and promote the highest level of scientific integrity, public accountability, and social responsibility in the conduct of science.
Center for Disease Control
The Centers for Disease Control and Prevention (CDC) is recognized as the lead federal agency for protecting the health and safety of people - at home and abroad, providing credible information to enhance health decisions, and promoting health through strong partnerships. CDC serves as the national focus for developing and applying disease prevention and control, environmental health, and health promotion and education activities designed to improve the health of the people of the United States.
Agency for Healthcare Research and Quality
The Agency for Healthcare Research and Quality (AHRQ) research provides evidence-based information on health care outcomes; quality; and cost, use, and access. Information from AHRQ's research helps people make more informed decisions and improve the quality of health care services. AHRQ was formerly known as the Agency for Health Care Policy and Research.
Agency for Toxic Substances and Disease Registry
The mission of the Agency for Toxic Substances and Disease Registry (ATSDR), as an agency of the US Department of Health and Human Services is to serve the public by using the best science, taking responsive public health actions, and providing trusted health information to prevent harmful exposures and disease related to toxic substances. ATSDR is directed by congressional mandate to perform specific functions concerning the effect on public health of hazardous substances in the environment. These functions include public health assessments of waste sites, health consultations concerning specific hazardous substances, health surveillance and registries, response to emergency releases of hazardous substances, applied research in support of public health assessments, information development and dissemination, and education and training concerning hazardous substances.
Food and Drug Administration
The Food and Drug Administration is one of the nation's oldest and most respected consumer protection agencies. Stated most simply, FDA's mission is to promote and protect the public health by helping safe and effective products reach the market in a timely way, and monitoring products for continued safety after they are in use.
Health Resources and Services Administration
The Health Resources and Services Administration's mission is to improve and expand access to quality health care for all. Its goal is moving toward 100 percent access to health care and 0 health disparities for all Americans. The Access Agency of the U.S. Department of Health and Human Services, HRSA assures the availability of quality health care to low income, uninsured, isolated, vulnerable and special needs populations and meets their unique health care needs.
Substance Abuse and Mental Health Services Administration
SAMHSA is the Federal agency charged with improving the quality and availability of prevention, treatment, and rehabilitative services in order to reduce illness, death, disability, and cost to society resulting from substance abuse and mental illnesses.
American's with Disabilities Act Homepage
The American's with Disabilities Act website is an information resource for changing regulations and information regarding the American's with Disabilities Act.
Last updated on 4/18/2023 3:12:13 PM