The sign in front of your office helps patients find their way to you. So does your contact information in the online Highmark provider directory — if you keep it up to date and accurate.
If you want Highmark members to be able to find you, make sure your practice name, physician team, locations, and contact information are correct in the Highmark provider directory. These are the facts members use 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 is up to date and is attested to on a quarterly basis.
The Centers for Medicare & Medicaid Services (CMS) requires Highmark to reach out to you every quarter and ask you to validate your provider information. We use this information to populate our provider directory and to help ensure correct claims processing.
Providers who don’t confirm and attest that their data is accurate will be immediately removed from the directory, and their status within Highmark’s networks may be impacted.
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 data at least 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 help our agent to gather the right information.