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CLAIMS FILING ADDRESSES – PA CENTRAL, EASTERN, AND ...
content.highmarkprc.comComprehensive Major Medical Highmark Blue Shield P.O. Box 898819 Camp Hill, PA 17089 -8819 Medigap . Signature 65 . Highmark Blue Shield P.O. Box 898845 Camp Hill, PA 17089 -8845 Children ’s Health Insurance Plan (CHIP) PPO Plus . Highmark Blue Shield P.O. Box 890173 Camp Hill, PA 17089 -0173 All other medical -surgical claims
Highmark Blue Shield Medical Management and Policy ...
content.highmarkprc.com3.1.2016 CLINICAL DOCUMENTATION AND Name of Requestor/Contact Person Requestor’s Phone Number Member ID Number Patient Name Patient Phone Number
Highmark Blue Shield Medical Management and Policy ...
content.highmarkprc.comRevised 3.1.2015 Name of Requestor/Contact Person: _____ Patient’s Name: Patient Phone # Patient’s Address: Date of Birth: Member UMI: Suffix # Provider Contact Name: _____