During the year, Highmark adjusts the List of Procedures and Durable Medical Equipment (DME) Requiring Authorization. For information regarding authorizations required for a member’s specific benefit plan, providers may:
Please note that the Highmark member must be eligible on the date of service and the service must be a covered benefit for Highmark to pay the claim.
You may use NaviNet or the applicable HIPAA electronic transactions to:
If you are not signed up for NaviNet or do not have access to the HIPAA electronic transactions, please call Clinical Services to obtain an authorization for services: