Highmark Blue Shield would like to welcome newly contracted providers located in Southeastern Pennsylvania (SEPA) who, effective January 1, 2024, will begin serving our commercial, Affordable Care Act (ACA), and self-insured members.

To help you get acquainted with working together, we would like to introduce you to some of the resources we have available to help you in your interactions with Highmark and our members.

Provider Portal: Availity

Highmark Blue Shield uses Availity Essentials as its provider portal — a resource for providers to assist in their transactions with Highmark. Through Availity providers can check eligibility and benefits, submit authorization requests, file claims, review payments from Highmark Blue Shield and more.

If you are registered for Availity with another payer, Highmark is now available to you. If you are not registered for Availity, you can do so today by CLICKING HERE.

We have a special section on our Provider Resource Center dedicated to Availity. We are also offering the following live Availity training sessions for SEPA providers:

Training Session	Date/Time (ET)
Availity Essentials Introduction and Authorization Workflow General Navigation Manage My Organization Eligibility and Benefits Inquiry Payer Spaces with Authorization Workflow (Predictal)	Wednesday, January 3, 2024, 8-9 a.m.
Claim Submission Applications Claims Submission Claims Reporting	Thursday, January 4, 2024, 12-12:45 p.m.
Claims Follow-Up and Payment Applications Claim Status Remittance Viewer Fee Schedules Messaging	Friday, January 5, 2024, 8-8:45 a.m.

If you are unable to attend one of the live training sessions above, you can find additional educational materials on Availity’s training websites:

• Training Site For Highmark Providers
• Explore Training Options for Highmark Providers

Provider Resource Center

Highmark’s Provider Resource Centers contain helpful information and tools to assist you in your daily interactions with Highmark and its members. The sites contain information such as important announcements and updates, prior authorization information, medical policies, provider newsletters, administrative manuals, pharmacy policies, forms, and much more.

The website for Highmark Blue Shield is hbs.highmarkprc.com. We encourage you to become familiar with this extensive online resource.

There is even a special section for SEPA region providers, which you can find in the left-hand menu.

Some important recent communications for SEPA providers include:

• New NAIC Code for SEPA Region Facility Claims Effective January 1, 2024 (November 13, 2023)
• BlueCard Changes for Southeastern PA (September 25, 2023)

New PRC Site Coming Soon

We are rolling out a new Provider Resource Center with easier wayfinding, improved readability of content, and a refreshed look and feel which better reflects Highmark’s brand. A beta version of the site will be available on December 28, 2023. We’d like you to explore the new site and provide us with your feedback; however, our legacy Provider Resource Center should be your main source of information until we complete our transition to the new site(s). You can read more about the new PRC HERE.

Provider Service

Highmark Blue Shield’s dedicated Provider Service number is up-and-running and accepting phone calls. Clinical Service Representatives are also ready to handle calls from SEPA providers.

Provider Service	844-945-5525
Medical Clinical Service	800-452-8507
Behavioral Health Clinical Service	800-628-0816

You can also find those numbers on our Contact Sheet, which you can bookmark for easy access.

Thank you for joining our Southeastern Pennsylvania network and for providing care to our members. We are happy to have you as part of our Highmark family.