Joining our network is easy!

We’re glad to hear that you are interested in joining the Medicaid network for Highmark Blue Cross Blue Shield (Highmark BCBS). We have a diverse network of exceptional health care professionals that ensure our members have uninterrupted access to the health care they need.

You make your patients' lives better. We will do the same for you.

Our precertification, referrals, claims and payment processes are streamlined to help you focus on what you do best — caring for your patients.

Application request

We are happy to talk with you about joining the Medicaid network for Highmark BCBS. To inquire about participating, please send a letter of interest to us via email.

Credentialing with Highmark BCBS

Credentialing is the process Highmark Blue Cross Blue Shield uses to evaluate and select licensed independent practitioners to provide care to our members.

Highmark BCBS uses the Council for Affordable Quality Healthcare (CAQH) ProView application for credentialing. This secure and private website reduces the amount of paperwork you need to fill out to complete the credentialing process.

Credentialing overview

Credentials are evaluated according to criteria set forth in our policy to ensure the competency and conduct of the health care professionals serving members in our network.

Credentialing process

All providers applying for initial or continuing participation are required to complete and submit their credentialing and recredentialing applications through CAQH ProView. Below are some helpful hints and things to remember when using ProView.

  1. Register with CAQH (if you are not already registered). You may also self-register via a secure and private website.
  2. Authorize Highmark BCBS so we can access your credentialing information. If you already registered with CAQH, you will need to give us permission to review your information. (If you selected Global Authorization, Highmark BCBS will already have access to your data.)

To authorize Highmark BCBS:

  1. Go to https://proview.caqh.org/pr and enter your username and password.
  2. Select the cogwheel in the upper right and then select Authorize.
  3. Scroll down, locate Highmark BCBS and check the box beside Highmark BCBS.
  4. Select Save to submit your changes.

For questions about ProView, call the CAQH help desk at:


Call:

1-888-599-1771

Email:

providerhelp@proview.CAQH.org

Provider tools and resources

Interested in becoming a provider in the Highmark BCBS network?

We look forward to working with you to provide quality service for our members.