Highmark Health Options West Virginia utilizes NaviNet as our provider portal. You can use NaviNet to verify member eligibility and benefits information, conduct claims search inquiries, connect to the appropriate prior authorization portals, and more.
You can reference our instructions to Create Your Highmark Health Options NaviNet Account for assistance integrating your existing account or registering for a new account.
Additionally, you can reference the NaviNet and Provider Portal Training Guide to learn how you can use the various self-service functions within our provider portal.
Participating providers must submit authorizations electronically through GuidingCare, via NaviNet for all services requiring authorization from our Utilization Management Department. Reference the GuidingCare User Guide to learn about the portal’s member search functionality, member eligibility, authorization requests, and more.
Prior authorization requests for the following services must be submitted through HealthHelp:
To request prior authorizations and check status in HealthHelp, follow the instructions for HealthHelp: Single Sign-On Capabilities through the NaviNet provider portal.
Find out if prior authorization from Highmark Health Options is required for medical procedures and services by using the Prior Authorization Code Lookup tool.
We can help. Review the Prior Authorizations section of the Provider Manual. Call Provider Services at 1-833-957-0020, Monday–Friday, 8 a.m.–5 p.m. Or contact your Provider Account Liaison.