Contact Us

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Questions or Comments?

To assist you most efficiently, please choose from the information below that best describes your area of interest.

Medicaid Member Contact
Information

Toll Free Numbers

Member and Provider Services 1-800-392-1147
Family Health Council 1-800-532-9465
Health Choices 1-800-440-3989

TDD/TTY: 711

Mailing Addresses
Claims and Referral Forms Mailing:
Highmark Wholecare
Claims Processing
P.O. Box 211713
Eagan, MN 55121

Claims Inquiries and Administrative Reviews (Provider Disputes):
Highmark Wholecare
Attention: Claims Review
444 Liberty Ave, Suite 2100
Pittsburgh, PA 15222

Send us a request by fax to:
1. All Providers 1-844-207-0334

Clinical Provider Appeals:
Highmark Wholecare
Attention: Provider Appeals Department
P.O. Box 22278
Pittsburgh, PA 15222

Send us a request by fax to:
1. Non-Participating Medicare Provider, and any Pre-Service Appeals: 412-255-4503
2. All Post Service appeals for Participating (Contracted Providers) and all Medicaid Providers: 855-501-3904

Member Complaints and Appeals:
Highmark Wholecare
Attn: Member Appeals Department
P.O. Box 22278
Pittsburgh, PA 15222
Fax: 412-255-4503

Fraud, Waste, and Abuse:
If you suspect Fraud, Waste, or Abuse please click here.

Medicare Assured Member Contact Information

Toll Free Numbers
Pennsylvania 1-800-685-5209 

TDD/TTY: 711

8:00 AM - 8:00 PM Eastern Time
7 Days a week from October 1 through March 31.
* From April 1 through September 30 our business hours are 8 a.m. - 8 p.m., Monday through Friday.

Mailing Addresses
Medical and Behavioral Health Claim Forms (PA Medicare Assured)
Highmark Wholecare
Claims Processing Center
P.O. Box 211164 
Eagan, MN 55121

Claims Inquiries and Administrative Reviews (Provider Disputes):

Highmark Wholecare
Attention: Claims Review
444 Liberty Ave, Suite 2100
Pittsburgh, PA 15222

Clinical Provider Appeals:
Highmark Wholecare
Attention: Provider Appeals Department
P.O. Box 22278
Pittsburgh, PA 15222

Send us a request by fax to:
1. Non-Participating Medicare Provider, and any Pre-Service Appeals: 412-255-4503
2. All Post Service appeals for Participating (Contracted Providers) and all Medicaid Providers: 855-501-3904

Member Complaints and Appeals:
Highmark Wholecare
Attn: Member Appeals Department
P.O. Box 22278
Pittsburgh, PA 15222
Fax: 412-255-4503

Fraud, Waste, and Abuse:
If you suspect Fraud, Waste, or Abuse please click here.

General Phone Number
412-255-4640

Mailing Address
Highmark Wholecare
444 Liberty Ave, Suite 2100
Pittsburgh, PA 15222

If you are an Agent interested in selling our products, please call  Agent Support at 1-888-871-0417.

Holiday Schedule

Please be aware that our offices are closed on the following holidays. If an answering service is reached, please leave a message and your call will be returned as soon as possible. 

- New Year's Day
- Martin Luther King, Jr. Day
- Memorial Day
- Independence Day (observed)
- Labor Day
- Thanksgiving Day
- Day After Thanksgiving
- Christmas Eve (observed)
- Christmas Day (observed)

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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.

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