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  2. For Providers
  3. Updates and Notices
ACTION REQUIRED!

Comply with the 21st Century Cures Act by registering NPI(s), taxonomies, and service location(s) with Delaware Medical Assistance Portal (DMAP) by Sept. 30, 2023. Failure to enroll with DMAP before this deadline will lead to denied claims with no option for reprocessing and potential termination from network participation. Enroll now!

Updates and Notices

Read the latest faxes and communications to Highmark Health Options providers.
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2023
picture_as_pdfChanges to the Prior Authorization List.
picture_as_pdfJoin us for the November Provider Forum.
picture_as_pdfUpdated medical policy for enteral feeding in-line cartridge.
picture_as_pdfAuthorizations and Care Plans through NaviNet
picture_as_pdfRegister for the joint MCO provider forum.
picture_as_pdfAnnouncing the Specialty Split Fill Program.
picture_as_pdfEarn CME/CEU With a Highmark Professional Education Webinar: Demystifying Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS)
picture_as_pdfMedical policy for back-up ventilators in the home setting services.
picture_as_pdfRegister for the 2nd Joint MCO Provider Forum
picture_as_pdfReimbursement policy for Scanning Computerized Ophthalmic Diagnostic Imaging.
picture_as_pdfEarn $100 for submitting the Obstetrical Needs Assessment Form.
picture_as_pdfJoin us for the September Provider Forum.
picture_as_pdfRegister for the Joint MCO Provider Forum
picture_as_pdfFind training and continuing education with the HHO Provider Training Portal.
picture_as_pdfSummer 2023 Provider Newsletter
picture_as_pdfBetter communication leads to better health care.
picture_as_pdfEffective October 1, 2023: Updated Reimbursement Policies
picture_as_pdfReimbursement policy for chiropractic benefits and services.
picture_as_pdfNo cost in-home A1c and FIT test kits for eligible members.
picture_as_pdfJoin us for the August Provider Forum
picture_as_pdfElectronically submit claims to HHO via NaviNet.
picture_as_pdfPaper claims must be completely and correctly filled out to be processed.
picture_as_pdfJuly Provider Forum Invite
picture_as_pdfSpecialty Pharmacy Management Update
picture_as_pdfEffective July 29, 2023: Genetic testing services will require prior authorization.
picture_as_pdfMDM Expansion Update July 2023
picture_as_pdfChanges coming for school-based wellness center claims.
picture_as_pdfICD-10-CM Official Guidelines and Reporting Excludes Notes reimbursement policy.
picture_as_pdfJune Provider Forum Invite
picture_as_pdfSpring 2023 Provider Newsletter
picture_as_pdfEffective July 30, 2023, claims without the billing and rendering codes will be denied.
picture_as_pdfEffective July 2, 2023: Updated Reimbursement Policies
picture_as_pdfEffective June 18, 2023: Changes to the Prior Authorization List
picture_as_pdfEffective June 15, 2023: Authorization requirements are no longer waived for COVID-19-related services
picture_as_pdfMay Provider Forum Invite
picture_as_pdfEffective May 1, 2023: Updated PA and APRN reimbursement policy
picture_as_pdfPatients may lose Medicaid. Here are ways you can help during the renewal process.
picture_as_pdfEffective June 1, 2023: Quarterly Medical Policy Changes
picture_as_pdfNARCAN Highmark Health Options Formulary Announcement
picture_as_pdfEffective May 17, 2023: Therapy Services reimbursement policy update
picture_as_pdfEffective May 10, 2023: Ambulance, Clinical Trials, and Dialysis reimbursement policy updates
picture_as_pdfApril Provider Forum Invite
picture_as_pdfEffective May 4, 2023: Changes to the Prior Authorization List
picture_as_pdfEffective May 3, 2023: Colorectal cancer screening policy update
picture_as_pdfAccess immunization records through the Immunization Registry, part of the Delaware Immunization Program
picture_as_pdfReminder: Members should not be balance billed by any participating provider
picture_as_pdfEffective April 22, reimbursement policy for chiropractic services
picture_as_pdfMarch Provider Forum Invite
picture_as_pdfBill Continuous Glucose Monitoring (CGM) systems through the Pharmacy benefit.
picture_as_pdfEffective Apr. 3, Updated Quarterly Medical Policy Changes.
picture_as_pdfWinter 2023 Provider Newsletter
picture_as_pdfEffective Apr. 3, Updated Reimbursement Policies
picture_as_pdfUse participating providers for genetic testing requests.
picture_as_pdfChanges to the Prior Authorization List
picture_as_pdfReview the payment policies for Federally Qualified Health Centers (FQHC) claims
picture_as_pdfFeb. Provider Forum Hosted by Clinical Quality
picture_as_pdfNew Pediatric Respite Benefits
picture_as_pdfAlert: Norditropin® Drug Shortage
picture_as_pdfEffective Jan. 20, 2023, check and EFT payments will occur weekly
picture_as_pdfEffective Jan. 1, 2023, New Medical Record Standard: Document Member Consent for Virtual Visits
picture_as_pdfJoin us for a Virtual Provider Lunch and Learn Hosted by Pharmacy Services
picture_as_pdfEffective Jan. 1, 2023, New Timely Access Standard for Behavioral Health Providers
2022
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