Jan 29, 2019, 10:18 AM
Highmark to Implement New Opioid Management Measures, Effective Feb. 1
Effective Feb. 1, 2019, Highmark will implement a 90 MME/day limit for opioid-naïve patients and members currently receiving less than 90 MME.
Jan 15, 2019, 09:52 AM
How Will Highmark’s New Prior Authorization Program Impact Physicians and Patients?
On Jan. 10, 2019, a stakeholder group which included PAMED met with Highmark to discuss the Advanced Imaging and Cardiology Services Program.
Dec 12, 2018, 11:18 AM
United Healthcare to Retire 10 Prior Authorization Fax Numbers
Find out why UHC is eliminating these numbers and what it means for physicians.
Oct 24, 2018, 14:40 PM
Highmark to Change Outpatient Services and Out-of-Network Services Reimbursement Policies
Both revised policies will take effect on Nov. 1, 2018.
Sep 11, 2018, 12:00 PM
Proposed CVS-Aetna Merger Could Jeopardize Patient Safety, Quality of Care in Pennsylvania
PAMED called for a public hearing to explore the possible implications of CVS-Aetna merger.
Aug 7, 2018, 14:58 PM
Highmark Efficiency Report (Webinar Recording)
Highmark has launched its Specialist Efficiency Report pilot program, aimed at analyzing and comparing care costs among providers. This webinar explains.
Jul 26, 2018, 08:55 AM
Pa. Supreme Court Issues Decision in Highmark-UPMC Medicare Advantage Case
In-network access to UPMC hospitals ends June 30, 2019 for certain Highmark Medicare Advantage plans.
May 31, 2018, 08:55 AM
Medical Societies to Independence Blue Cross: Share Data on Modifier 25 Use
PAMED joined a coalition of 47 medical societies who asked for the data that led to the adoption of the IBC's modifier 25 payment policy, so that they could better understand why the policy was implemented.
Mar 28, 2018, 13:46 PM
Highmark Conducting Outreach to Verify Provider Directory Details – Is Your Info Accurate?
Highmark has announced that it is making provider outreach calls to verify the accuracy of data in its provider directory. Get these tips to make sure your data is accurately listed in provider directories.
Feb 12, 2018, 15:22 PM
Applying Topical Fluoride Varnish in the Medical Office Setting for Children
Get guidance on how to provide topical fluoride varnish applications, including training requirements and associated billing/reimbursement.
Jan 25, 2018, 15:30 PM
IBC Policy Changes Affect Pathology Credentialing and Reimbursement
Independence Blue Cross (IBC) announced a two-part policy change regarding the credentialing and reimbursement of office-based pathology services.
Oct 2, 2017, 18:45 PM
PAMED Calls for Retroactive Delay of IBC’s Modifier 25 Payment Policy
Effective Aug. 1, 2017, Independence Blue Cross changed its policy on payment when Modifier 25 is used. PAMED strongly opposes this policy change.