Authorization Training & Resources

Highmark's Predictal Auth Automation Hub utilization management tool allows offices to submit, update, and inquire on authorization requests. Predictal is accessible via Highmark's Payer Spaces in Availity. To learn more about registering and getting started with Availity, go to the Register and Get Started with Availity Essentials webpage.

• For guidance on how to set up your organization in Availity, please review our Manage My Organization user guide.

We have a number of resources available to assist providers in the prior authorization process.

Instructional Videos

Click the links below to view the videos.* If you experience an issue, please refresh your browser. If the issue persists, contact resourcecenter@email.highmark.com.

• Electronic Authorization Submission Process (General)

• Submitting a Prior Authorization for Outpatient PT, OT, Chiro
• Submitting a Prior Authorization for Home Health
• Submitting a Prior Authorization for Inpatient Hospice
• Submitting a Prior Authorization for Inpatient Rehab Facility Services
• Submitting a Prior Authorization for Outpatient Speech Therapy
• Submitting a Prior Authorization for Skilled Nursing Facility

Case Management Referral

• Case Management Referral Process (Predictal via Availity)

Extension Request

• Submitting an Extension Request
• Submitting an Extension Request for Outpatient PT, OT, Chiro

Guides

• Inpatient Authorization Submission (Both Urgent and Non-Urgent)
• Outpatient Authorization Submission

Additional Resources

• Behavioral Health Tip Sheet for Submitting Authorization Requests
  
• Guide to Out-of-Network Gap Exception Requests
• MCG Guidelines Product Acronym List

Frequently Asked Questions

Additional training resources can be found on our Provider Training page.

PROVIDER TRAINING

Video Disclaimer

*By accessing the videos above, I understand that I am leaving the Highmark PRC website and will be redirected to an external website operated by a third-party platform provider. Any use of the third-party platform provider’s website and any information you provide will be subject to and governed by the terms of the third party, including those relating to confidentiality, data privacy, and security.