Join Our Network


Cultural Competency Data Form

Please help us improve the Highmark Wholecare member experience by completing the Cultural Competency Data Form. By providing your race, ethnicity, language and cultural competency training data, you allow Highmark Wholecare to better connect members to the appropriate practitioners, deliver more effective provider-patient communication and improve a patients’ health, wellness and safety.

Join our network by completing this form.

If your practice is already contracted with Highmark Wholecare but need to make a change, like one of the changes listed below, please complete the Practice Change form.
• Address Changes;
• Phone & Fax number changes;
• Changes of hours of operation;
• Primary Care Practice (PCP) panel status changes (Open, Closed & Existing Only);
• Practitioner participation status (additions & terminations) and;
• Mergers and acquisitions.

If your practice is already contracted with Highmark Wholecare but need to add a new physician please complete the Provider Data Form to initiate Credentialing.


Please email the completed roster to: [email protected].

Are you currently participating with Highmark Wholecare? *
Which Line(s)-of-Business are you interested in applying for? * Medicaid Provider Manual
Medicare Provider Manual
Do you currently accept PA Medicaid? * Per our HealthChoices Agreement (HCA) we are required to ensure that all providers operating within the PH-MCO’s network who provide services to recipients must be enrolled in the Commonwealth’s MA program and possess an active MMIS Provider ID for each location in which they provide services to our members.
Do you currently accept Medicare? * Active participation in the Medicare and/or Medical Assistance Programs; free of sanctions.
Is your practice a Federally Qualified Heath Center (FQHC) or Rural Health Clinic (RHC)?: *
Are you Board Certified?: *


This information is issued on behalf of Highmark Wholecare, coverage by Gateway Health Plan, which is an independent licensee of the Blue Cross Blue Shield Association. Highmark Wholecare serves a Medicaid plan to Blue Shield members in 13 counties in central Pennsylvania, as well as, to Blue Cross Blue Shield members in 27 counties in western Pennsylvania. Highmark Wholecare serves Medicare Dual Special Needs plans (D-SNP) to Blue Shield members in 14 counties in northeastern Pennsylvania, 12 counties in central Pennsylvania, 5 counties in southeastern Pennsylvania, and to Blue Cross Blue Shield members in 27 counties in western Pennsylvania.

Copyright 2022 by Highmark WholecareSM