Provider Portal Transition

Transition From NaviNet to Availity Starts October 2023

Highmark is replacing its existing provider portal, NaviNet®, with Availity® Essentials later this year. Availity serves plans nationwide, including many Blue Cross Blue Shield Association licensees like us. Availity’s multi-payer platform will support the existing payer-provider transactions necessary to manage care for Highmark members, including eligibility and benefits, claim status, and claim submission, and serve as a gateway to our utilization management platform to perform authorization transactions.

 

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Why is Highmark Moving to Availity?

With provider feedback and the future vision of Highmark’s digital platforms in mind, we evaluated the advantages of our current provider portal and areas where we can improve. We looked closely at our opportunities to offer an enhanced online experience and found that Availity meets many of the criteria that will help us better serve you.

 

When is the Transition Happening?

August & September 2023

Highmark will engage a pilot group of providers to ensure a seamless transition to the Availity portal.

October 22, 2023

Providers who currently use Availity for other payers will see Highmark as an option in the states in which they are contracted. Providers who are newly contracted with Highmark after October 22, 2023 may register for Availity.

February 5, 2024

Availity will be available to all Highmark providers.

March 2024

 Providers will no longer have access to NaviNet or HEALTHeNET (NY).*

*More information on the retiring of existing portals will be distributed as it becomes available. If you don’t already receive emails for our provider newsletters, join our eSubscribe list today.

Highmark Wholecare and Highmark Health Options will not transition to Availity; providers should continue to use their current portals for transactions related to these plans.

 

Will Availity Have the Same Capabilities as NaviNet?

Providers will be able to perform all the same tasks as they do today — eligibility and benefit searches, authorization submission and status check, claims submissions and inquiries, view reporting, etc. The interface to perform some of these transactions may look different, but we will provide a crosswalk document that maps functions from their current locations in NaviNet to where they appear in Availity — in addition to training opportunities.

  

What Do Providers Need to Do for This Transition?

If your organization is already registered with Availity, you do not need to re-register. You may only need to review the Highmark-specific features once they are live.

If your organization is not already registered with Availity, you should register for access starting January 10, 2024, or soon thereafter. For details, go to the Register and Get Started with Availity Essentials webpage.

 

Training

Availity will offer both live and on-demand training to providers. Training session dates and information will be posted on the Provider Resource Center when available. We will also email your organization if you have signed up for our eSubscribe list. (Information on how to sign up below, under Stay Up to Date.)

The first three training sessions will be offered between October 23, 2023, and November 3, 2023. They will cover the following topics:

  • Availity Essentials: Introduction to Highmark Providers (including Highmark’s Authorization Tool)
  • Claim Submission Applications for Highmark Providers
  • Claim Follow-up and Payment Applications for Highmark Providers

To attend, you must be registered with Availity. All registered providers will receive an email invitation for the training sessions.

  

Stay Up to Date

Highmark will share more information regarding registration and training in the coming months. Make sure that you are signed up for our eSubscribe list. You can do so by clicking the eSubscribe button at the top right of the homepage.

Once subscribed, you will receive Highmark’s monthly newsletter, Provider News, with the latest information about the transition to Availity Essentials.

Highmark will also post communications here on the Provider Resource Center and Availity may announce new features and training opportunities on their in-portal message center.

 

For Help

For Availity Client Services assistance, call 1-800-AVAILITY (282-4548) or, within the Availity portal, click Help & Training and then click on Availity Support.

We also have a special section on the Provider Resource Center that includes additional background information and Frequently Asked Questions. You will find it at the top of the left-hand menu. We will continue to update this section throughout the transition to Availity.

Last updated on 10/17/2023 1:45:26 PM

 

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