Credentialing by payer
Join the Highmark Blue Cross Blue Shield Network
- Flat PricesNo percentage of collections
- Half Now, Half at SubmissionFor every enrollment application
- Closed Network?Your choice of a refund or a credit
- Live Status TrackingCheck any application by reference number
Highmark Blue Cross Blue Shield at a Glance
| Parent company | Highmark Health |
|---|---|
| Service area | Delaware; central, northeastern and western Pennsylvania; West Virginia; western and northeastern New York. |
| How to request to join | Highmark's Initial Credentialing Request Form with your CAQH ID. In Delaware, since August 3, 2026, the form hands off to the CertifyOS intake portal. Start here |
| Portal | Availity (status under Payer Spaces in Provider Data Maintenance or Provider File Management) |
| CAQH ProView (DataSpring) | Yes, exclusively: Highmark credentials from CAQH ProView (DataSpring). West Virginia also requires its state Uniform Credentialing Form, which can be entered in CAQH. |
| Published turnaround | New York: notice within 60 days of a complete application. West Virginia: a decision within four months, extendable by three if verification is delayed. Denials go out in writing within 60 calendar days. |
| Recredentialing | At least every three years (within 36 months of the last credentialing). |
| Lines of business | Commercial and Medicare Advantage (practitioners who opted out of Medicare cannot see MA members); Medicaid eligibility is confirmed at initial credentialing where it applies. |
How Highmark Blue Cross Blue Shield Takes Applications
Highmark has no separate network application for individuals: you send the Initial Credentialing Request Form with a CAQH ID and Highmark works from the CAQH (DataSpring) profile, verifying it within 120 days of your attestation signature. Delaware now routes the request into CertifyOS, where you create an account, upload PDFs and complete the Highmark Provider Application.
What to Watch With Highmark Blue Cross Blue Shield
Licensed social workers in Delaware and Pennsylvania are enumerated rather than credentialed. Physician assistants are not eligible for New York Medicaid. Highmark's corporate site also lists members in Missouri and Kansas, which are outside the Highmark BCBS credentialing described here.
Whatever the plan, the file moves only when your CAQH (DataSpring) profile, license record and application agree. See how long credentialing takes and our CAQH profile setup service.
Questions About Highmark Blue Cross Blue Shield
How do I apply to Highmark Blue Cross Blue Shield?
Highmark's Initial Credentialing Request Form with your CAQH ID. In Delaware, since August 3, 2026, the form hands off to the CertifyOS intake portal.
How long does Highmark Blue Cross Blue Shield credentialing take?
New York: notice within 60 days of a complete application. West Virginia: a decision within four months, extendable by three if verification is delayed. Denials go out in writing within 60 calendar days. Recredentialing: At least every three years (within 36 months of the last credentialing).
Does Highmark Blue Cross Blue Shield use CAQH (DataSpring)?
Yes, exclusively: Highmark credentials from CAQH ProView (DataSpring). West Virginia also requires its state Uniform Credentialing Form, which can be entered in CAQH.
What does PECS charge for a Highmark Blue Cross Blue Shield application?
$200 per application per provider, half at engagement and half at submission, including follow-up with Highmark Blue Cross Blue Shield until the effective date is set.
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Answers cover PECS services, prices and process. For legal, tax or clinical questions please consult a professional.
Sources
- Highmark provider manual: Professional provider credentialing
- Highmark: Credentialing with the CertifyOS platform
- Highmark Health corporate profile 2025
Facts checked against the sources above in October 2026; plan procedures change.