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Important Legal Information: Health care benefit programs are issued or administered by Highmark Blue Cross Blue Shield Delaware or Highmark Health Insurance Company, independent licensees of the Blue Cross and Blue Shield Association, an association of independent Blue Cross Blue Shield plans.The RFP was released by the Delaware Department of Health and Social Services (DHSS), Division of Medicaid and Medical Assistance (DMMA) on December 15, 2021. DSHP/DSHP Plus provides integrated physical, behavioral health, and longterm services and supports (LTSS) to approximately 280,000 members. Delaware intends to contract with two or three ...HCPC/CPT Code Modifier Effective Date Non-Facility Rate Percent A4232 2015-01-01 2.11 0.0000 A0021 2015-01-01 16.00 0.0000 A0130 2015-01-01 1.00 0.0000Highmark Health Options has a team to walk you through your benefits, so you can get the most out of Medicaid. For other questions about your benefits, start by calling Member Services at 1-844-325-6251, Monday-Friday, 8 a.m.-8 p.m. For adults age 21 and older, your coverage goes beyond the basics—even when you're not sick—so you can ...to very little for their health coverage. Highmark Health Options currently serves Delaware Medicaid: Delaware Healthy Children Program (DHCP) and Diamond State Health Plan and Health Plan Plus members. Odynophagia - Painful swallowing. POLICY POSITION 1. A diagnostic EGD may be considered medically necessary for ONE of the following conditions:Delaware Medicaid program available from Highmark® Health Options. Our high quality healthcare provides coverage & access to the doctors and hospitals you need.You can also find participation information in Chapter 3 of the Highmark Provider Manual. To access the manual, select MANUALS on the Quicklinks Bar located at the top of the Provider Resource Center. Contact Provider Services in your service area with any questions. Last updated on 9/29/2023 1:29:11 PM.Together. Highmark Health Options and the network of providers give work together to give high quality health care to those who need it most: adults and children eligible for Medicaid. These are members enrolled in the Diamond State Health Plan (DSHP), Delaware Healthy Children Program (DHCP), and DSHP Plus Long-term Services and Supports. Highmark Health Options offers the quality care and access to the benefits you need: Access tools and programs to help you maintain a healthy lifestyle and manage your health conditions. Choose from a large network of doctors, hospitals and specialists, including vision service providers. ... 800 Delaware Avenue, Wilmington, DE 19801.the State of Delaware and Federal agencies such as the Center of Disease Control. Please check our website often for any changes. To broaden access to telehealth services during the COVID-19 public health emergency, Highmark Health Options is temporarily waiving the CMS and state-based originating site restrictions for all members.Welcome to the Highmark Health Options Medicaid Formulary. This formulary includes medications in the Delaware Medical Assistance Program (DMAP) Preferred Drug List (PDL) and medications which are not otherwise covered in the PDL. You can search the formulary in several ways.The Delaware Department of Health and Social Services (DHSS) has expanded its Medicaid managed care program by adding a Centene health plan. Centene's Delaware Health First will join Highmark Health Options Blue Cross Blue Shield, which began operating in Delaware in 2015, and AmeriHealth Caritas, which began in 2018.Highmark Health Options Member Services is available Monday-Friday, 8 a.m.-8 p.m. If you have a question about your coverage or how to enroll, check the member handbook.. ATENCIÓN: Si usted habla español, servicios de asistencia lingüística, de forma gratuita, están disponibles para usted.Para asistencia en español llame al 1-844-325-6251.Highmark Health Options 2019 Member Handbook. Diamond State Health Plan Plus LTSS . For inquiries, pleasecall Member Services at . 1-855-401-8251 . ... are no longer eligible or you change your health plan. DMMA: Delaware D ivision o f Medi caid and Medi cal Assistance. DSS: Division o f S o cial Servi ces . Emergency medical condition:Nick Moriello is the Segment President of Highmark Blue Cross Blue Shield Delaware, assuming the role in August of 2018. Before joining Highmark Blue Cross Blue Shield Delaware, Mr. Moriello ran his own agency, Health Insurance Associates (HIA). Under his leadership, HIA grew to be one of the largest independent health insurance agencies in the ...800 Delaware Avenue, Wilmington, DE 19801. Highmark Health Options is an independent licensee of the Blue Cross Blue Shield Association, an association of independent Blue Cross Blue Shield Plans. Highmark Health Options is a wholly-owned subsidiary of Highmark Health.Highmark Delaware members can access gym memberships, weight loss programs, a discount on massage therapy and other wellness discounts on the Highmark Delaware Member website. Log in to learn more. Discounted Gym Memberships Find a local gym that has partnered with the State of Delaware, Statewide Benefits Office to offer discounted pricing.Call Provider Services at 1-844-325-6251, Monday-Friday, 8 a.m.-5 p.m. Provider forms and reference materials are housed here to provide easy access for our Highmark Health Options Medicaid providers.For us, a remarkable experience is the result of smoothing out the complex parts of health care and breaking down the barriers between people and their healthiest lives. When you join our award-winning health organization, you're an integral part of those remarkable experiences. You're coming to a team that's full of diverse perspectives ...Highmark Health Options, a Delaware Medicaid managed care program, helps more than 164,000 members get the care and services they need to live healthier and more independent lives. In addition, Highmark Western New York provides Medicaid enrollment to 58,000 members in the 8 counties of western New York.Formulary Updates. This page includes information on the bi-monthly updates to our formularies and pharmaceutical management procedures. Highmark Commercial Core Formulary. This website allows you to view the Highmark Commercial Core Formulary by drug name or therapeutic class. Highmark Commercial National Select Formulary.

Highmark Health Options is a Medicaid managed care plan offered through the Delaware Diamond State Health Plan. Managed care means: We work with your primary care physician (PCP) to manage all your health care needs. You go to health care providers in our network. Your PCP is very important in managing your care. Get the Most from Your Benefits AmeriHealth Caritas Delaware Medicaid; Highmark Health Options Delaware Medicaid; Both programs include a $3 copay for dental services and a maximum benefit limit of $1,000 per calendar year. Another $1,500 is available for authorized emergency dental care. Qualifications: Must meet income limits and qualify for Delaware's Medicaid or DHCP ...Highmark Health Options, a Delaware Medicaid managed care program, helps more than 164,000 members get the care and services they need to live healthier and more independent lives. In addition, Highmark Western New York provides Medicaid enrollment to 58,000 members in the 8 counties of western New York.A. You can find out if you qualify for Medicaid or other medical assistance and social service programs by speaking with a representative at your local State Service Center. Call Medicaid Customer Relations at 1-800-372-2022 or (302)255-9500 to be directed to the appropriate office where someone can help you. Q.Highmark Reimbursement Policy Bulletin Bulletin Number: RP-046 Subject: Telemedicine and Telehealth Services Effective Date: July 15, 2019 End Date: Issue Date: July 10, 2023 Revised Date: July 2023 Date Reviewed: May 2023 Source: Reimbursement Policy PURPOSE: This policy outlines the Plan's reimbursement for telemedicine, telehealth, virtual-care, or eVisit services.

Some Health Options recipients have other insurance coverage. Health Options, like Delaware’s Department of Health and Social Services (DHSS, is the payer of ) last resort on claims for services provided to members any commercial or with Medicare plan covers the memberHealth Options may not delay or deny . For information about mediation, call the DOI Consumer Services Division at 302.674.7300 or 800.282.8611, email them at [email protected] or visit the DOI office Monday through Friday, 8:00 AM - 4:30 PM at: 841 Silver Lake Boulevard, Dover, Delaware, 19904. Please note that the 180-day appeal deadline will still apply if you choose mediation ...About Highmark Health. Highmark Health, a Pittsburgh, PA-based enterprise that employs more than 35,000 people who serve millions of Americans across the country, is the parent company of Highmark Inc., Allegheny Health Network, and HM Health Solutions. Highmark Inc. and its subsidiaries and affiliates provide health insurance to more than 6 ...…

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