Availity Enhancement & Issue Tracker

ECHO Check Number Display

Providers will no longer have to go to Cash Management to retrieve the check number (Vendor Payment #) — they will now see it in Claim Status.  

Claim Status view will including ECHO check number.

October 18, 2024

Benefit Period Display

For members who have started to meet their deductible or out of pocket benefits, the Benefit Period will display in the Eligibility & Benefits response (271) benefits

Providers will now be able to see if members have an annual benefit period or a contract benefit period. 

October 18, 2024

Remit Viewer Registration

(DE, PA, and WV only)

This functionality requires the vendor draft # and not the Highmark check #. The draft number can be viewed in Cash Management.

The vendor draft # will be available on a claim status response screen in the future.

TBD

Claim Status

The following fields are missing/incomplete on the response screen:

• Payee information
• DRG Code - Facility
• Type of Bill – Facility

Missing/incomplete fields will be added to the response screen.

TBD

Authorizations Being Cancelled Incorrectly

Authorizations submitted via Availity's authorization workflow may be cancelled incorrectly. The error displaying is: "PPO Opt-Out."

NOTE: If the authorization is required, go to Payer Spaces and then access Predictal to submit your authorization.

Authorizations will not be cancelled and Availity's authorization workflow will function correctly.

TBD

Claim Status

• Member UMI displaying as "XXXX"
• Modifiers not showing on claim status view

Missing/incomplete fields will be added to the response screen.

August 2024

Quick Claims

(DE only. This functionality is already available for NY, PA, and WV.)

Allows providers to create templates that pre-populate certain fields when submitting a CMS-1500 claim.

Providers will have access to Quick Claims for Highmark members.

June 6, 2024

Additional Benefits Page in E&B Not Displaying Pharmacy Benefits

The additional benefits page in E&B is not displaying pharmacy benefits.

Pharmacy benefits will be displayed on the additional benefits page.

May 18, 2024

Spending Account Payment Information

(NY only)

Spending account payment information is currently not being returned.

Spending account payment information will be available.

April 2024

Quick Claims

(NY, PA, and WV only)

Allows providers to create templates that pre-populate certain fields when submitting a CMS-1500 claim.

Providers will have access to Quick Claims for Highmark members.

April 20, 2024

Secondary Modifiers Not Returning on Claim Status

Only the primary modifiers are showing on Claim Status response claim line detail. 

Show all modifiers associated with a claim line on Claim Status responses.

April 13, 2024

Out of Area Authorizations

If the user is entering an authorization for an Out of Area (OOA) member, they need to continue use NaviNet. 

OOA authorizations will be Available in Availity's authorization workflow.

March 18, 2024

Ancillary Providers - Fee Schedule Application

A Provider ID needs to be included in the request. Ancillary providers do not have individual providers setup on their accounts and users cannot select a Provider ID this field, preventing it from being able to be completed. 

The full fee schedule is available on the Provider Resource Center. Access by signing into Availity > Payer Spaces > Highmark > Provider Resource Center

March 16, 2024

Secure Messaging

Attachment size currently allows for a total 45MB for 1 – 10 attachments.

Allow for attachment total size of 100MB for 1 – 10 attachments.

Feb. 17, 2024

Authorization Submission

Currently, authorizations can only be submitted by going to Payer Spaces > Highmark > Predictal.

Users will be able to also use the Availity Authorizations workflow (for submissions only).

In the Availity Essentials menu bar, click Patient Registration | Authorizations & Referrals > Authorizations.

The Predictal tile must still be used for authorization status and inquiry.

Dec. 2023

Authorizations for Outpatient Physical Medicine Services

(DE, PA, WV only)

If the user is entering an outpatient physical medicine authorization, they currently submit via NaviNet to Tivity. 

Authorizations for these services are available for submission in Availity and Predictal tile.

Dec. 4, 2023

Additional Benefits/Member ID Cards

If a date prior to the current date is inputted in the Eligibility request, the Additional Benefits and Member ID Card buttons will not display. User must enter in the current or a future date to view.

Will allow view of benefits/ID cards for previous dates.

Nov. 11, 2023

Claim Status - Member Search

If the user is entering the member prefix in the member ID field, the alpha-characters need to be capitalized.

Update will ensure alpha-characters are not case sensitive.

Nov. 11, 2023

Claim Status - Member and Claim Tabs

Secondary modifiers are not currently returned on response screen.

Update will allow secondary modifiers to be viewable.

Nov. 11, 2023