Highmark’s Self-Service Tools: Get More Done Faster

Over the past few years, Highmark has made significant investments in our self-service tools to reduce administrative burden, improve office workflows, and simplify complex transactions — allowing you and your staff to focus on delivering care to our members.

As a result of this evolution, Highmark requires providers to utilize our enhanced self-service tools to obtain the fastest resolution to many common issues and tasks. This enables our Provider Service advocates to assist with more complex issues, while allowing your staff to avoid unnecessary hold times on the telephone.

The following self-service tools — which are available 24/7 — can help you and your team accomplish more in less time:

  • Availity Essentials, Highmark’s Provider Portal – the primary method for submitting transactions to Highmark and accessing reports, including:

    • Authorization Submission
    • Claim Submissions / Investigations
    • Credentialing (Initiate Application, Submit Change, Review Status)
    • Eligibility and Benefits Check
    • Value Insights Center (Value-Based Program Reporting Tool)

  • Highmark’s Provider Resource Center (PRC) – the main hub for important information, including policies, procedures, the Highmark Provider Manual, and Provider News.

  • Interactive Voice Response (IVR) System – The Provider Service Center offers options for you to access information, such as claim status or member benefits, without a live agent.

Additional Resources

Highmark just launched a new Self-Service Tools page on the PRC to help providers and their teams to maximize these resources. By familiarizing yourself with these tools, you’ll be able to increase office efficiencies and get more done faster.

For easy reference, download our Self-Service Support Chart by clicking here.


 

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