Has it been a while since you tried using our provider portal or Interactive Voice Response (IVR)? Highmark continues to enhance its self-service tools to deliver a simpler, better coordinated experience for providers. The provider portal and IVR can help providers reduce administrative costs, improve office workflows, and assist in the collection of claim payments.
Starting November 13, 2023, we are encouraging providers to use these tools as the primary way to check authorization status and submit authorizations for the quickest answers/determinations.
Highmark offers guides for various authorization types located on its Provider Resource Center. Choose Authorizations in the left-hand navigation bar.
Availity shares recorded trainings — including how to navigate to Predictal — by logging into Availity Essentials and then choosing Help & Training > Get Trained.
Providers who currently use Availity Essentials for other payers will now be able to access Highmark in the regions in which they are contracted. (Providers who are newly contracted with Highmark may also register to use Availity at this time.)
You can easily check the status of your authorization or submit an authorization within Availity by following these steps:
More information about the Availity transition can be found on the Provider Resource Center. Click Availity in the left-hand navigation bar.
If you are not currently registered with Availity to transact with other payers, you can continue to check authorization status or submit an authorization in NaviNet until February 5, 2024, when your access to Availity will begin. In the meantime, you can check authorization status in NaviNet by following these steps:
Interactive Voice Response (IVR) System
Highmark’s automated, interactive Voice Response (IVR) telephone system is available 24 hours a day, 7 days a week, and allows providers to inquire about authorization status.
IVR Tip – Have Your Reference Number Ready
If you used the portal for your original authorization request, you obtained the reference number at the end of your submission.
Highmark’s Provider Resource Center
More information about the end-to-end authorization process, including workflow guides, may be found on our Provider Resource Center (PRC). Look under AUTHORIZATIONS > Procedures/Service Requiring Authorization. You will also find details regarding the Availity transition on the PRC.