Annual Provider Training

Highmark Wholecare invites providers to attend the 2024 Provider Education and Orientation Training to learn about topics such as EPSDT, access/accessibility surveys, Fraud, Waste, and Abuse, Model of care, self-service tools, Cultural Competency, claims, and more! The training is on-demand and can be viewed at your convenience. Register here.

UM Transitions

Important UM Authorization Updates: Effective May 1st, there are updates to the authorization requirements and processes for various Highmark Wholecare services. To learn more about these specific changes and to review reference materials, visit the following links: Musculoskeletal/Pain Management, Diagnostic Imaging and Physical Medicine Family Planning Cardiology

Change Healthcare Cyber Incident Banner

Important Provider Notice - March 5, 2024 - Change Healthcare Event: Highmark Wholecare Claims/Remittance Update - Please click here for more information. Additionally, to learn more about how Highmark Wholecare is assisting providers impacted by the Change Healthcare cyber event, click here.

E-Subscribe Provider Website Banner

The Highmark Wholecare Provider Newsletter has been replaced with the Provider News monthly email. The Provider News email will become our primary communications channel, allowing us to consolidate and simplify updates for you each month. Subscribe here to stay up-to-date with Highmark Wholecare member programs, provider policies, claims, reimbursement, and more!

GuidingCare Provider Website Banner

Providers now have access to a new Clinical Platform, GuidingCare. This platform allows access to an Authorization Portal via NaviNet. Please utilize this online capability as the preferred method to submit your authorization requests. To learn more about accessing this new platform, please review the provider guide here.

 

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