![]() ![]() All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Timely Filing Timely filing is a Highmark Blue Shield requirement whereby a claim must be filed within a certain time period after the last date of service relating to such claim or the payment/denial of the primary payor, or it will be denied by Highmark. Highmark Western and Northeastern New York Inc., serves eight counties in Western New York under the trade name Highmark Blue Cross Blue Shield of Western New York and serves 13 counties in Northeastern New York under the trade name Highmark Blue Shield of Northeastern New York. If a provider or capitated entity fails to submit. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Final disputes must be submitted within 65 working days of Blue Shields initial determination. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration.Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. The Highmark Blue Shield Office Manual contains information that explains if/when medical records are necessary to submit and how to submit them. From time to time, you may have questions about submitting medical records to Highmark. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Reminders About Submitting Medical Records. You should submit the original (not a copy) with your claim. A receipt - Your doctor will give you an itemized receipt for all the services you received. Paper claim forms must be submitted on original red claim forms. ![]() Highmark Health Options processes medical expenses upon receipt of a correctly completed CMS-1500 form for professional services and upon receipt of a correctly completed UB-04 form for hospital or facility expenses. A claim form - signed and completed for each member or patient who received care. Claims, Payment, and Reimbursement Policies. The result is medical trend that is deliciously below the industry benchmark. Our expert claim analysts review high-cost claims to capture billing errors, waste and abuse, and to negotiate savings opportunities. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. To avoid delays and have your claims processed accurately, be sure you submit all of the following: 2. Trustmark's 2.6 three-year medical trend is leading the industry. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania.
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