All PlansAdministrativeMedium impact
Is Your Provider Directory Information Still Accurate?
Highmark·PA, DE, NY, WV·Provider Bulletin
We identified it
May 7, 2026
Summary
Highmark requires all providers to verify and update their provider directory information every 90 days to maintain compliance with CMS mandates. This includes verifying practitioner details, contact information, specialties, and new patient acceptance status through designated portals.
Action Required
Every 90 days: Professional providers must use the Provider Data Maintenance (PDM) tool within Availity Essentials to verify all practitioner information including names, NPIs, specialties, contact details, and new patient acceptance status. Facility providers must use the Highmark Facility/Ancillary Change Form. Failure to validate quarterly may result in removal from provider directory and impact network status.