HealthHelp Transition: Sign Up for Molecular Lab Prior Auth Training

As previously communicated, HealthHelp will manage prior authorizations for genetic/molecular lab testing across Highmark’s four-state footprint, effective Oct. 1, 2026. 

To prepare for this transition, training will be offered on the following dates:

• Tuesday, Sept. 15, 9–10 a.m. EST
• Friday, Sept 18, 12–1 p.m. EST

Topics include:

• A live system demo
• Navigating the HealthHelp portal
• Submitting auth requests via the WebConsult tool
• Q&A session

By registering, you will have access to both sessions, allowing you flexibility to attend. To register, click here.

Reminder: Regional Impact

• Delaware, Pennsylvania, and West Virginia – HealthHelp is replacing eviCore, the vendor that currently manages prior authorizations for lab services. The majority of prior authorization codes currently managed by eviCore will be managed by HealthHelp. Due to this transition, additional genetic/molecular lab management codes will require prior authorization, effective Oct. 1.
• New York – Currently, most genetic/molecular lab testing services do not require prior authorization. Beginning Oct. 1, prior authorization requirements will expand to include a broad range of genetic and molecular testing codes.

Submission Process

Providers will continue to submit initial authorization requests for genetic/molecular lab tests through Highmark’s provider portal, Availity Essentials. Once the initial auth request is submitted in Availity, providers will be routed via Predictal to HealthHelp’s auth portal via single sign-on (SSO) to continue the submission process.

Note: During the initial transition period, some member and provider information may need to be re-entered in HealthHelp’s authorization portal. We recognize the importance of a smooth experience and are actively working to simplify and improve the intake process.