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Prior Authorization Submission Help and Tips

Highmark·Provider Bulletin
Effective date
Not stated
We identified it
Dec 5, 2025
Days to comply

Summary

Highmark has implemented a new prior authorization submission process requiring all medical prior auth requests to be submitted through Availity Essentials via the Authorizations and Referrals workflow, not via fax or Predictal. The system has been updated to eliminate confusion and streamline the workflow with specific buttons and processes that must be followed.

Action Required

Action needed
Immediately: Stop faxing prior authorization requests. All medical prior authorization requests for inpatient and outpatient services must be submitted through Availity Essentials using the Authorizations and Referrals workflow starting from the Patient Registration tab. After submitting each request, click the Exit AAH button to prevent technical errors. For submission issues, contact Availity Client Services at 800-242-4548 instead of faxing. Continue using Predictal only for extensions, concurrent requests, discharge requests, and responding to requests for additional information.

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