Checklist for the New Year: Verify Your Networks Starting Jan. 1

Every year, Highmark makes adjustments to its networks. As some networks have changed for 2026, we encourage all providers to verify which networks you’re participating in at the start of the new year.

Here are steps you can take to confirm your Highmark network status — and make sure your patients don’t incur any unexpected costs.

1) Verify Your Network Status

You can view your network status using our self-service tools.

Professional Providers:

• Log into Availity Essentials.
• Navigate to Highmark's Payer Spaces.
• Select the appropriate health plan payer.
• Go to Applications.
• Select the Provider Data Maintenance (PDM) tool.

Facility and Ancillary Providers:

• Call Provider Service for your region and a representative can provide details on your network status.

2) Check Member Eligibility

Verify member eligibility and benefits before appointments through Availity's Patient Registration feature. This helps ensure members receive in-network care and avoid unexpected costs.

You will need the Member ID, date of birth, and specific service information.

3) Verify Network Status for Referrals

Confirm that the provider you’re referring a member to is in-network for the member's plan. You or your patients may use our online Provider Directory to verify in-network provider participation at any time. Find step-by-step instructions HERE.