We’re Listening: Streamlining Credentialing for a Better Experience
Mon, Oct 27, 2025
We understand that Highmark’s credentialing process has not always been the easiest to navigate. We've heard your valuable feedback and are excited to share how your insights have directly led to recent improvements designed to enhance your experience. We are actively working to create a more efficient and seamless credentialing journey for you and your organization.
Enhancing Our Systems
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- New Credentialing Platform – Launching Nov. 3, 2025: Based on your feedback seeking quicker turnaround times, we are updating our current credentialing platform, which will now be powered by CertifyOS. This significant upgrade is designed to improve turnaround times for credentialing applications and provide more robust verification of provider qualifications, ultimately making the process faster and more efficient for you.
- Organizational Providers – Our previous forms have been consolidated into a single enrollment form for organizational providers, regardless of specialty — a direct result of requests for simpler processes.
- IMPORTANT: While the new form will be available on Nov. 3, it won’t link to the Certify portal until a later time. Highmark will ensure that Certify receives all credentialing applications.
- Professional Providers – Continue to use the Initial Credentialing Request Form on the Provider Resource Center (PRC). At the end of the form, you will click a link that integrates with the credentialing portal, powered by CertifyOS.
- For more information on the move to Certify, CLICK HERE.
- Organizational Providers – Our previous forms have been consolidated into a single enrollment form for organizational providers, regardless of specialty — a direct result of requests for simpler processes.
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- New Professional and Organizational Credentialing Platform – Launching in 2026: Based on your feedback seeking quicker turnaround times, we are making updates to improve turnaround times for credentialing applications and provide more robust verification of provider qualifications, ultimately making the process faster and more efficient for you. Provider News will have more details soon.
- Upgraded Delegated Credentialing Technology – Live! We recognize the administrative burden faced by our delegated credentialing partners. That's why we've implemented automated roster loading. This eliminates manual data entry, reduces errors, and improves overall efficiency in managing your provider networks, saving you valuable time.
Dedicated Support Channels
- New Credentialing Phone Support – In response to requests for more direct support, we recently launched live phone assistance for providers with questions about credentialing, standard contracts, and the provider file directory. This dedicated line is designed to get you the answers you need quickly.
- How to Reach the Team: Simply call your regional Provider Service Center and select the Credentialing option from the Interactive Voice Response (IVR) menu.
- Credentialing Status Inquiry Form – Submit credentialing status inquiries directly to Highmark’s credentialing team through this form on the Provider Resource Center. Our team strives to complete our reviews promptly upon receipt and we’re committed to providing updates in a timely manner.
Self-Service Options
We understand the value of quick and convenient access to information. Our online resources remain the fastest way to make updates to your practices information or check network status.
- The Provider Data Management (PDM) tool in the Availity Essentials portal enables professional providers to complete tasks, such as updating practice demographic information or practitioner affiliations.
- The Provider Resource Center (PRC) has a variety of credentialing forms for both professional and facility providers, as well as the PDM Guide.
We are committed to continuous improvement. There are many more enhancements we are working on to make the credentialing process truly efficient and seamless. We encourage you to continue sharing your feedback with us as we explore new ways of working together and build an even stronger partnership. Thank you for your vital role in caring for our members.
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