Availity Enhancement & Issue Tracker

Below is a list of upcoming enhancements and known issues involving transactions for Highmark Inc. providers within our provider portal(s).

 

Upcoming Enhancements

Details

Targeted Resolution

Release Date

Status

Known Issues

Details Targeted Resolution Release Date Status

Remit Viewer Registration

(DE, PA, and WV only)

This functionality requires the vendor draft # and not the Highmark check #. The draft number can be viewed in Cash Management.

The vendor draft # will be available on a claim status response screen in the future. TBD OPEN
Claim Status

The following fields are missing/incomplete on the response screen:

  • Payee information
  • Member UMI displaying as "XXXX"
  • Modifiers not showing on claim status view
  • DRG Code - Facility
  • Type of Bill - Facility
Missing/incomplete fields will be added to the response screen. TBD OPEN
Authorizations Being Cancelled Incorrectly

Authorizations submitted via Availity's authorization workflow may be cancelled incorrectly. The error displaying is: "PPO Opt-Out."

NOTE: If the authorization is required, go to Payer Spaces and then access Predictal to submit your authorization.

Authorizations will not be cancelled and Availity's authorization workflow will function correctly. TBD OPEN

Resolved Items

Details

Resolution

Date Completed

Status

Quick Claims

(DE only. This functionality is already available for NY, PA, and WV.)

Allows providers to create templates that pre-populate certain fields when submitting a CMS-1500 claim.

Providers will have access to Quick Claims for Highmark members.

June 6, 2024

CLOSED

Additional Benefits Page in E&B Not Displaying Pharmacy Benefits

The additional benefits page in E&B is not displaying pharmacy benefits.

Pharmacy benefits will be displayed on the additional benefits page.

May 18, 2024

CLOSED

Spending Account Payment Information

(NY only)

Spending account payment information is currently not being returned.

Spending account payment information will be available.

April 2024

CLOSED

Quick Claims

(NY, PA, and WV only)

Allows providers to create templates that pre-populate certain fields when submitting a CMS-1500 claim.

Providers will have access to Quick Claims for Highmark members.

April 20, 2024

CLOSED

Secondary Modifiers Not Returning on Claim Status

Only the primary modifiers are showing on Claim Status response claim line detail. 

Show all modifiers associated with a claim line on Claim Status responses.

April 13, 2024

CLOSED

Out of Area Authorizations

If the user is entering an authorization for an Out of Area (OOA) member, they need to continue use NaviNet. 

OOA authorizations will be Available in Availity's authorization workflow.

March 18, 2024

CLOSED

Ancillary Providers - Fee Schedule Application

A Provider ID needs to be included in the request. Ancillary providers do not have individual providers setup on their accounts and users cannot select a Provider ID this field, preventing it from being able to be completed. 

The full fee schedule is available on the Provider Resource Center. Access by signing into Availity > Payer Spaces > Highmark > Provider Resource Center

March 16, 2024

CLOSED

Secure Messaging

Attachment size currently allows for a total 45MB for 1 – 10 attachments.

Allow for attachment total size of 100MB for 1 – 10 attachments.

Feb. 17, 2024

CLOSED

Authorization Submission

Currently, authorizations can only be submitted by going to Payer Spaces > Highmark > Predictal.

Users will be able to also use the Availity Authorizations workflow (for submissions only).

In the Availity Essentials menu bar, click Patient Registration Authorizations & Referrals Authorizations.

The Predictal tile must still be used for authorization status and inquiry.

Dec. 2023

CLOSED

Authorizations for Outpatient Physical Medicine Services

(DE, PA, WV only)

If the user is entering an outpatient physical medicine authorization, they currently submit via NaviNet to Tivity. 

Authorizations for these services are available for submission in Availity and Predictal tile.

Dec. 4, 2023

CLOSED

Additional Benefits/Member ID Cards

If a date prior to the current date is inputted in the Eligibility request, the Additional Benefits and Member ID Card buttons will not display. User must enter in the current or a future date to view.

Will allow view of benefits/ID cards for previous dates.

Nov. 11, 2023

CLOSED

Claim Status - Member Search

If the user is entering the member prefix in the member ID field, the alpha-characters need to be capitalized.

Update will ensure alpha-characters are not case sensitive.

Nov. 11, 2023

CLOSED

Claim Status - Member and Claim Tabs

Secondary modifiers are not currently returned on response screen.

Update will allow secondary modifiers to be viewable.

Nov. 11, 2023

CLOSED

  

Additional Education/Resources

Payer Spaces

  • Users should only select the Organization on the SSO login screen. "Select a Provider" is optional and if selected may not return or provider the proper information the user is looking for. Highmark processes transactions at the Organization/Group level.
  • The only exception to this rule is "Provider Facing Analytics." A provider is required.

 

Applications via Payer Spaces

  • Users may be having issues accessing Applications via Payer Spaces. If a user is presented with an additional login screen, please contact Availity to open a ticket. Highmark is looking into this issue and hopes to have it resolved soon.
    • Availity Contact Information: 1-800-AVAILITY (282-4548)
    • Available Monday through Friday, 8 a.m. to 8 p.m. Eastern time
Last updated on 7/11/2024 9:40:47 AM

 

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