To help ensure that outpatient physical medicine services (physical therapy, occupational therapy and manipulation services) provided to our members are consistent with nationally recognized clinical guidelines, Highmark has contracted with WholeHealth Networks, Inc. (WHN), a subsidiary of Tivity Health Support, LLC., to administer a registration process for physical medicine services as well as to provide medical necessity review and authorization, where applicable, for these services, effective with dates of service of Sept. 1, 2012, and beyond.
Learn More About the Physical Medicine Management Program
- Medical Doctors, Doctors of Osteopathic Medicine, Doctors of Chiropractic, CRNPs, Physical Therapists and Occupational Therapists
- Hospital and Skilled Nursing Facilities
- Highmark to Introduce Physical Medicine Management Program, Effective September 1, 2012, issued June 15, 2012 (Facility Bulletin search keyword: physical medicine)
- Physical Medicine Management Program – Important Updates
- Highmark's Physical Medicine Management Program began Sept. 1, 2012. As you begin to follow the program, we are committed to providing ongoing updates and the information you need during the Program's implementation. Read important updates and check back often for the most current information
Please continue to look for future communications from us on this topic, and check the Plan Central page of NaviNet, Today’s Messages on the Provider Resource Center and upcoming issues of Provider News for additional tools and information to assist you in the program's authorization process.
The following documents/forms include information that supports the Physical Medicine Management Program; the purpose of each is fully explained in the Administrative Guide above.
Outcome Assessment Tool
Reconsiderations and Appeals
Advisory Committee Meeting Minutes
- March 22, 2016
- August 4, 2015
- May 5, 2015
- February 3, 2015
- November 4, 2014
- August 18, 2014
- May 6, 2014
- February 4, 2014
- November 19, 2013
- May 7, 2013
- February 5, 2013
- November 6, 2012