New State Mandate: Prior Authorization Requests Must Be Submitted Electronically Starting July 1

We’re less than a week away from July 1. That’s the date when the West Virginia law (Senate Bill 267 signed into law during the 2023 Regular Session of the WV Legislature) mandating the electronic submission of prior authorization requests via the insurers’ electronic portal goes into effect.

Is your organization ready for this change? Have you already started using Availity®, Highmark’s provider portal, to submit prior authorization requests electronically? If so, great!

Many of your West Virginia colleagues, who formerly faxed or phoned in prior authorization requests, are now submitting prior authorizations electronically. These providers are discovering the benefits of electronic transactions via Availity, which include increased administrative efficiency, reduced costs, and faster turnaround times.

Based on Highmark Utilization Management data, using Availity increases authorization turnaround time by 75% compared to alternative submission channels; some approvals are available immediately.

Getting Started with Availity

Not signed up for Availity? Visit www.availity.com and click the Get Started link.

Both Highmark and Availity have plenty of resources, including guides and videos, to assist you through the electronic authorization process.

Highmark Resources

Availity Resources

  • Log into Availity.
  • Select the Help & Training tab on the homepage:
    • Click Get Trained from the dropdown menu to view recorded demos and webinars.
    • Search Highmark for Highmark-specific courses.
    • “Availity Essentials Introduction for Highmark Providers - Recorded Webinar” contains guidance on submitting authorizations starting at 00:29:38 in the video.

Registration Guides

Reference Guides


 

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