What are patients seeing when they look at your information in the Highmark provider directory?
Is your practice name correct? Are all practitioners listed?
We want Highmark members to have the most reliable information about your practice, so they are able to make informed decisions on where to seek care. That’s why it’s essential that the practice information you have on file with Highmark remains up to date and is attested to on a quarterly basis.
Providers who don’t validate and attest that their data is accurate will be immediately removed from the directory, and their status within Highmark’s networks may be impacted.
The Centers for Medicare & Medicaid Services (CMS) requires Highmark to conduct a quarterly outreach to validate provider information. We use this information to populate our provider directory and to help ensure correct claims processing.
Each review confirms:
It’s vital that all providers review and update their information in Provider File Management within NaviNet®. All fields should be completed with your up-to-date information, including your current address, phone number, and fax number. Information should be updated as soon as a change occurs. All data should be reviewed at a minimum of once a quarter to ensure it’s accurate. Detailed instructions are available in the Provider File Management NaviNet Guide, which is available on the Provider Resource Center under Education/Manuals.
Highmark and its designated agent, Atlas, are currently making outreach calls to providers to verify the accuracy of provider data. If you receive a call, please provide our agent with the requested information.