The sign in front of your office helps members find their way to you. Your contact information in the online Highmark provider directory does the same.
You are required to supply Highmark with your practice name, clinical team, locations, and contact information for our provider directory. It is essential that Highmark has your up-to-date information in order to help our members make informed decisions on where to seek care. You are required to supply Highmark with your information 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.
Per the No Surprises Act, providers who don’t confirm and attest that their data is accurate will be immediately removed from the provider directory, and their status within Highmark’s networks may be impacted.
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 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.
Atlas is an independent company that performs outreach to physicians on behalf of Highmark.