When Highmark members are looking for a PCP or specialist, they expect that our online provider directory presents information that is accurate and current.
That’s why it is essential to ensure that your practice information on file with Highmark remains up to date.
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. We use this information to populate our provider directory and to help ensure correct claims processing.
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’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.