A newsletter for Highmark Blue Shield providers in central Pennsylvania, the Lehigh Valley, northeastern Pennsylvania, and southeastern Pennsylvania
Issue 5, May 2024
Highmark has recently experienced an uptick in claim submissions with the Service Facility Location information either missing or incorrectly filled out, leading to claim denials or processing delays. The Service Facility Location field is used to report the physical location where the services were actually performed.
If the services are rendered at a location that differs from either the billing address or the main facility location (e.g., hospital’s off-site outpatient surgery center), then the Service Facility Location field must be filled out completely and accurately on the submitted 837P, 837I and 1500 Health Insurance Claim Form.
It is also important to complete the Service Facility Location field to easily locate your patients’ medical records when necessary. Highmark requests records for Healthcare Effectiveness Data and Information Set (HEDIS®) and other quality improvement activities.
Identifying the place where services are rendered — by accurately filling out the Service Facility Location field — eliminates unnecessary calls to provider offices to locate medical records, saving administrative teams valuable time.
Important: A physical street address must be reported for the Service Facility Location — a P.O. Box or lock box will not be accepted.
If your organization has multiple locations where members are treated, all these locations should be listed as part of your provider directory information with Highmark. Every quarter, you are required to review and validate your provider directory information on file with Highmark.
Please be aware that providers who don't attest to their data quarterly may be removed from the directory and their status within Highmark’s networks may be impacted. To learn more about validating your directory information, see this article in the current issue of Provider News.
For more information on using the Service Facility Location field on claims, see the Highmark Provider Manual: Chapter 6, Unit 1: General Claim Submission Guidelines > Service Field Location.
To access the Provider Manual, go to the Provider Resource Center, select MANUALS from the taskbar, and click HIGHMARK PROVIDER MANUAL from the dropdown.
