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Advisory Committee

Highmark West Virginia has established a Provider Advisory Committee (PAC) to afford providers a mechanism to offer recommendations and comments to the Plan on provider billing, coding, and administrative issues.

The PAC may also serve as a forum to discuss regional or national issues regarding interactions among providers, their patients and health plans. This may include exploring ways to improve health care delivery, clinical quality, cost-effectiveness of services, communication and cooperation. Highmark West Virginia may also seek input from the PAC on proposed new initiatives or changes to existing programs that may affect providers.

The PAC will not address individual provider billing disputes or Highmark West Virginia medical policies, reimbursement levels, eligibility, or coverage rules.

At least a majority of PAC members will be participating providers in Highmark West Virginia's networks. At least three members will be selected from nominations submitted by the West Virginia State Medical Association. Members will represent different specialties and geographic areas, and include provider representatives who deal directly will billing, coding, and plan administrative issues.

Interested providers may attend PAC meetings either in person or via conference call. However, if it becomes necessary for the Committee to discuss personally identifiable health information or proprietary information, all non-PAC members except Highmark West Virginia employees will be excused from the meeting prior to the discussion of such information, in order to comply with federal and state privacy requirements or to protect proprietary information of the Plan.

A provider may submit an issue for consideration by the PAC by sending written comments, either by letter or email, to:

Medical Director, c/o Manager of Operational QI
Highmark Blue Cross Blue Shield West Virginia

P.O. Box 1353
Charleston, WV 25325
Phone: (304) 347-7681

Please be sure to include your own contact information in case Highmark West Virginia or the PAC need to contact you for additional information.

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Highmark Blue Cross Blue Shield West Virginia is an independent licensee of the Blue Cross Blue Shield Association, an association of Independent Blue Cross and Blue Shield Plans. The Blue Cross and Blue Shield symbols are registered marks of the Blue Cross and Blue Shield Association, an Association of Independent Blue Cross and Blue Shield Plans.

Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia and Washington County, Ohio.