Professional Credentialing
Last Updated: Tuesday, August 05, 2025
Highmark requires all professional providers to utilize the Council for Affordable Quality Health Care (CAQH) ProView® as the preferred method for initial credentialing.
The enrollment process follows two simple steps, completing your CAQH profile and submitting the Initial Credentialing Request to Highmark.
Step 1: Initial Applicant Registration
|
Applicant Type |
Requirement |
Action Required on the CAQH Website |
|---|---|---|
|
New Applicant (No CAQH provider ID) |
Create Your CAQH ProView® Profile |
Complete the full application to obtain your CAQH ProView® ID. |
|
Existing Applicant (Has a CAQH provider ID) |
Update Your CAQH ProView® Profile |
Review your data on the CAQH Portal and complete the necessary re-attestation. |
Note: In all cases, you must authorize Highmark to access your data electronically.
Step 2: Submit the Highmark Initial Credentialing Request
After ensuring your CAQH profile is accurate and Highmark is authorized, all providers must:
- Complete the Initial Credentialing Request Form.
- Include your verified CAQH ID on the form. CAQH is used for credentialing purposes only and not to update Highmark provider data.
Credentailing Details
Post-Submission and Status
|
I Want to… |
How to Proceed |
More Details |
|---|---|---|
|
Get in Touch with the Team |
For all your credentialing inquiries, call your regional Provider Service Center and select the Credentialing option from the IVR menu. |
|
|
Check Application Status |
This form is for credentialing & recredentialing status inquires ONLY, all other questions will not be reviewed and responded. |
|
|
Submit Facility-Based Details |
Providers who deliver care exclusively within an acute care hospital must complete the Facility-Based Provider Affirmation Statement. |
|
|
Update Information |
CAQH is only for credentialing. Use provider portal or PIM Forms to update your data (location, contact, etc.). |
Additional Resources
- Highmark Provider Manual – See Chapter 3 for detailed information on Provider Network Participation.
- Provider Guide to Credentialing
- What to Expect During Professional Credentialing
- wpa/ nepa
- cpa/ sepa
- de
- wv
- wny
- neny
New York Group Contracts
Highmark is in the process of moving professional providers in its New York markets onto Highmark Professional Agreements - which are group contracts that match the structure that is in place in the other Highmark service regions.
For more information, read our Frequently Asked Questions.
