Required Use of Provider Authorization Portal, Effective July 1

Effective July 1, 2024, Highmark Wholecare providers will be required to submit prior authorizations through our provider portal, GuidingCare, via NaviNet, pursuant to 40 PA Statute 991.2153. Should the portal be unavailable, providers can fax or call our Utilization Management team. The Utilization Management team can be reached by calling 1-800-392-1147 or through the fax numbers found on our provider website.

The GuidingCare User Guide is available on the Highmark Wholecare Provider Resource Center.

NaviNet® is a separate company that provides an internet-based application for providers to streamline data exchanges between their offices and Highmark Wholecare such as routine eligibility, benefits and claims status inquiries.