Highmark Radiology Management Program

Privileging Application and Requirements
This contains the Privileging Application and Requirements

Frequently Asked Questions (FAQs)
A document to help answer common questions regarding the Highmark Radiology Management Program

Prior Authorization / Notification Information
The Prior Authorization/Notification component of Highmark's Radiology Management Program requires all physicians and clinical practitioners to obtain prior authorization/notification when ordering selected outpatient, non-emergency, diagnostic imaging procedures for certain Highmark patients (This prior authorization/notification requirement doesn't apply to emergency room or inpatient scans.).

DIP Levels
Diagnostic Imaging Procedures (DIP) Levels

Privileging Appeal Process
Highmark has established a privileging requirement for providers seeking to bill for providing imaging services in the outpatient setting.

Privileged Provider Directory
This page contains links to 2 directories; the Premier Blue Shield Network-Central Region Radiology Privileged Providers and Hospitals and the Medicare Advantage PPO Network Central & Northeastern Regions Radiology Privileged Providers and Hospitals.

Clinical Guidelines
This link is designed to establish a pathway to clinical consensus on the use of a single or combination of Diagnostic Imaging examinations.

Radiation Safety Awareness
To protect our members, and assist our network physicians in doing the same, Highmark is launching a Radiation Safety Awareness Project. This project will identify for you those members who have been exposed to a threshold amount of ionizing radiation.


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