Ensure Your Directory Information Stays Current

Ensure Your Directory Information Stays CurrentWhen Highmark members are looking for a primary care physician (PCP) or specialist, they expect that our online provider directory presents information that is accurate and current.

That’s why it is essential to ensure that your practice information on file with Highmark remains up to date.

Please be aware that providers who don't validate their data quarterly may be removed from the directory and their status within Highmark’s networks may be impacted.

Reviewing Data Is Vital for You

The Centers for Medicare and Medicaid Services (CMS) requires Highmark to reach out to you every quarter and ask you to validate your provider directory information. We use this information to populate our online provider directory and to help ensure correct claims processing.

Your thorough review of your directory information confirms:

  • Each practitioner’s name is correct and matches the name on his/her medical license.
  • The practice name is correct and matches the name used when you answer the phone.
  • All specialties are correctly listed and are currently being practiced.
  • Practitioners listed at a location currently see members and schedule appointments at that office on a regular basis.
    • All practitioners listed must be affiliated with the group. Practitioners who cover on an occasional basis should not be listed.
  • The practitioner is accepting new patients — or not accepting new patients — at the location.
  • The practitioner’s address, suite number (if any), and phone number are correct.

Professional Providers – New PDM Tool

Beginning May 1, 2023, professional providers will be required to validate their Highmark Provider Directory information within the new Provider Data Maintenance (PDM) tool in NaviNet® every 90 days. They will no longer receive calls from Atlas or use PRIME, Atlas’ provider data management software, to update information.

To learn more about the new PDM tool, read the March 27 Special Bulletin .

Facility, Ancillary, and Medicaid Providers – Continue to Use Atlas.

The attestation process through Atlas is quick and easy. Just follow these steps…

  1. Go to hub.primeatlas.com .
  2. Log in.
  3. Review your information.
  4. If no changes, confirm.
  5. If there are changes, update your information.

If you haven’t attested your provider directory information this quarter, you will receive a letter from Atlas to review your provider information. Some providers may also receive emails from Highmark about validating their directory information through the Atlas website . To ensure delivery of emails from Highmark, please add the following email address, resourcecenter@highmark.com , to your address book.

During the attestation process, always double-check your current email address(es) to ensure that you can receive electronic communications from Highmark without delay.

If you need additional information regarding the attestation process, Atlas’ step-by-step guide is available on the Provider Resource Center.

 

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