Organizational Credentialing

The following specialties are currently closed to network enrollment:

• Skilled Nursing Facilities
• Home Health Agencies
  
• DME
• Orthotic & Prosthetics
• Laboratories
• Specialty Pharmacies

Highmark continually seeks ways to make its network credentialing process easier for our providers. We are required by federal law and the American Accreditation HealthCare Commission to initially credential providers who participate in Highmark's preferred provider networks and in Highmark's Medicare Advantage network.

This application is to be used by organizational providers only. Professional providers should select Credentialing in the top navigation bar, then Professional Credentialing.

Behavioral Health Application For Organizational Providers

Highmark performs outreach in the provider community when such services are determined to be a need. While closed network applicants are rarely considered, we do provide an option for special consideration. This process occurs before credentialing can begin.

Interested providers can complete the form below:

Special Consideration Questionnaire

Urgent Care Centers and Medical Aid Units provide Highmark members with a convenient option for non-life-threatening injuries and illnesses when their personal physicians are unavailable.

Urgent Care Center/Medical Aid Unit and Retail Clinic Application

• Initial Application for Facility and Ancillary Providers
  
• Organizational Provider Participation, Credentialing and Contracting Requirement
• Highmark Provider Manual Chapter 3, Unit 4

If you have recently received a letter stating that you must recredential, please use this form to enter the requested information.

Recredentialing Application

Please use this form to report any changes in ownership which may include the legal name, doing business as name, NPI (National Provider Identifier) or tax ID information.

Change of Ownership (CHOW) Form

Please use this form when needing to update address, phone numbers and contact information to existing locations for UB Facility Billers, Urgent Care Centers/Medical Aid Unit/Retail Clinics, or for Organizational Behavioral Health Billers.

Highmark Facility/Ancillary Change Form