Overview

Keeping in mind provider feedback and the future vision of Highmark’s digital platforms, we evaluated the advantages of our current provider portal and areas where we can improve. We looked closely at our opportunities to offer an enhanced online experience and found that Availity meets many of the criteria that will help us better serve you.

Availity’s expertise is in building and managing a provider portal with tools that are easy and useful to health care providers. The company continually seeks provider feedback to improve its website for all users. Benefits include:

• A single login and password that lets you check eligibility and benefits or the status of a claim for patients with coverage from multiple health plans without logging into different systems.
• Customized tools within Availity for Highmark information that will better meet your needs.
• Express Entry that lets you set up specific providers in the system so you can click on them from a dropdown menu and have information automatically populate. This means you don’t have to retype data, such as NPI numbers or provider names.
• Access to Highmark-specific resources through a dedicated payer space.

• Highmark Blue Cross Blue Shield (DE)
  
• Highmark Blue Cross Blue Shield (WNY)
  • New York state plans already use Availity for its Medicaid and CHP lines of business. Now Commercial, FEP, ACA and Medicare Advantage plans will be added.
• Highmark Blue Cross Blue Shield (WPA/NEPA)
  
• Highmark Blue Cross Blue Shield (WV)
• Highmark Blue Shield (CPA/SEPA)
• Highmark Blue Shield (NENY)

Highmark Wholecare and Highmark Health Options will not transition to Availity; providers should continue to use their current portals for transactions related to these plans.

There is no cost to providers to access it.