SEPA: Self-Service Tools Required for Claim Status and Investigation – Starting Nov. 1

Highmark will require providers in our Southeastern Pennsylvania (SEPA) service area to use our self-service tools for questions related to claim status and claim investigation beginning Nov. 1, 2026.

The Highmark Provider Service Center will no longer be able to give information regarding claim status and claim investigation for all lines of business, including the Federal Employee Program (FEP) and BlueCard. Instead, our representatives will direct providers to our self-service tools, which are available 24/7 and include the following:

• Availity Essentials, Highmark’s Provider Portal – The primary method for submitting transactions to Highmark and accessing reports, including: 
  • Authorization submission
  • Claim submissions and investigations – The use of Availity to check claim status and submit a claim investigation is required, effective Nov. 1, 2026.
  • Eligibility and Benefits check
  • Value Insights Center (value-based program reporting tool)
• Provider Chat – Offers digital support for common questions like claim and authorization status
  • Log into Availity, navigate to Highmark's Payer Spaces, and click Provider Live Chat to connect. Live agents are available for complex inquiries during weekday business hours
• Interactive Voice Response (IVR) – Quickly manage routine inquiries, such as claim status or member benefits, without a live agent via the Provider Service Center
• Highmark’s Provider Resource Center (PRC) – The main hub for accessing important information, including policies, procedures, the Highmark Provider Manual, and communications