Provider Portal Transition

Transition From NaviNet to Availity Starts October 2023

Highmark is replacing its existing provider portal, NaviNet^®, with Availity^® Essentials. Availity serves plans nationwide, including many Blue Cross Blue Shield Association licensees like us. Availity’s multi-payer platform will support the existing payer-provider transactions necessary to manage care for Highmark members, including eligibility and benefits, claim status, and claim submission, and serve as a gateway to our utilization management platform to perform authorization transactions.

Why is Highmark Moving to Availity?

With provider feedback and the future vision of Highmark’s digital platforms in mind, 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.

When is the Transition Happening?

*More information on the retiring of existing portals will be distributed as it becomes available. If you don’t already receive emails for our provider newsletters, join our eSubscribe list today.

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

Will Availity Have the Same Capabilities as NaviNet?

Providers will be able to perform all the same tasks as they do today — eligibility and benefit searches, authorization submission and status check, claims submissions and inquiries, view reporting, etc. The interface to perform some of these transactions may look different, but we will provide a crosswalk document that maps functions from their current locations in NaviNet to where they appear in Availity — in addition to training opportunities.

What Do Providers Need to Do for This Transition?

If your organization is already registered with Availity, you do not need to re-register. You may only need to review the Highmark-specific features once they are live.

If your organization is not already registered with Availity, you should register for access now (or as soon as possible). For details, go to the Register and Get Started with Availity Essentials webpage.

Training

Availity offers a wide range of training resources*, including:

• Live webinars conducted by Highmark and Availity trainers. Information on upcoming training webinars will be emailed to you. (If you're not already subscribed to receive our emails, join our eSubscribe list today.) Webinars cover the following topics:

• Availity Essentials: Introduction for Highmark Providers. Applications covered: General Navigation, Eligibility and Benefits Inquiry, Manage My Organization, Payer Spaces, and Authorizations.
• Claim Submission for Highmark Providers. Applications covered: Claim Submission and Claim Reporting.
• Claims Follow-up & Payment Applications for Highmark Providers. Applications covered: Claim Status, Remittance Viewer, Fee Schedules, and Messaging (Claim Investigations).

• Help & Training tab on the homepage:
• Click Get Trained from the drop-down menu to view recorded demos and webinars.

• Crosswalk document
• This helpful resource will show you how to find all the Availity tools and functions you need to work with Highmark.

*NOTE: You must be registered with Availity to access the training resources mentioned above.

Stay Up to Date

Make sure that you are signed up for our eSubscribe list. You can do so by clicking the eSubscribe button at the top right of the homepage.

Once subscribed, you will receive Highmark’s monthly newsletter, Provider News, with the latest information about the transition to Availity Essentials.

Highmark will also post communications here on the Provider Resource Center, and Availity may announce new features and training opportunities on their in-portal message center.

For Help

For Availity Client Services assistance, call 1-800-AVAILITY (282-4548) or, within the Availity portal, click Help & Training and then click on Availity Support.

We also have a special section on the Provider Resource Center that includes additional background information and Frequently Asked Questions. You will find it at the top of the left-hand menu. We will continue to update this section throughout the transition to Availity.