Highmark encourages providers to identify members who could benefit from coordinated case management services. You can submit referrals for Clinical Care and Wellness (CC&W) case management programs from Availity®.
This feature will help connect Highmark members who have chronic conditions and complex medical needs to the right clinical support.
Using this feature in Availity also simplifies and expedites the overall case management referral process, while reducing the administrative burden for providers.
To learn more about making case management referrals, watch the Case Management Referral Process (Predictal via Availity), which is available on the Provider Resource Center (PRC).
Once on the PRC, choose PRIOR AUTHORIZATION from the left menu, click Procedures/Service Requiring Prior Authorization, and then scroll down to the Videos section.