With the turn of the calendar to 2019, both new and returning Highmark members may be switching PCPs or looking for specialists. And they will be relying on Highmark’s online provider directory for accurate and current information about our network providers.
That is why it’s more important than ever to ensure that your practice information on file with Highmark remains up to date. We use this information to populate our provider directory and to help ensure correct claims processing.
Please be aware that providers who don't validate their data 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 reach out to you every quarter and ask you to validate your provider information.
Your thorough review of your directory information confirms:
It’s vital that you review and update your information as soon as a change occurs. Go to Provider File Management within NaviNet® to check these fields:
Remember to review your data at least once a quarter to ensure it is 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 help our agent to gather the right information.