[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-288212-105":53,"doc-detail-288212-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","highmark-provider-newsletter-issue-6-june-2025","Highmark Provider Newsletter - Issue 6 - June 2025","","Provider-facing newsletter for Highmark Blue Cross Blue Shield in western New York, Issue 6 (June 2025), delivering updates on prior authorization improvements and operational changes. Highlights include initiatives to simplify authorization requirements, reductions in turnaround time, increased electronic submission and automation, and technology enhancements such as Availity Essentials and electronic retrospective review. Additional coverage addresses expedited review for RadCard and MSKAuth requests effective Sept. 20, 2025, along with fee schedule timing, preventive schedule updates, claims guidance, administrative accessibility and directory accuracy.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":11,"@type":70,"position":76},"https://docshare.wps.com/template/presentations/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/highmark-provider-newsletter-issue-6-june-2025/288212/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/highmark-provider-newsletter-issue-6-june-2025/288212.png","ImageObject",442,249,{"name":88,"@type":89},"Riley","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-09-20","2026-09-17",true,{"@type":98,"interactionType":99,"userInteractionCount":73},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What changes are being made to simplify prior authorization requirements?","Question",{"text":108,"@type":109},"Highmark joined nearly 50 health plans to streamline and simplify prior authorization requirements. The newsletter also cites process improvements such as reduced turnaround time and increased electronic submission and automation.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"When will expedited review begin for RadCard and MSKAuth authorization requests?",{"text":113,"@type":109},"The enhanced submission process for RadCard and MSK authorization requests is effective Sept. 20, 2025, and providers may be asked for additional information to support quicker decisions.",{"name":115,"@type":106,"acceptedAnswer":116},"When does the annual fee schedule update take effect?",{"text":117,"@type":109},"The annual fee schedule update for Commercial products in New York regions takes effect on Sept. 1, 2025.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},288212,1789633242,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":8,"category_name":11,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":73,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":135,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":125,"read_time":140},1374391975076,"https://ap-avatar.wpscdn.com/avatar/14000253ca4ec9f6853?x-image-process=image/resize,m_fixed,w_180,h_180&k=1783305029341752051","A newsletter for the Highmark Blue Cross Blue Shield providers in western New York  \nIssue 6, June 2025  \nIN THIS ISSUE  \nHighmark Among Insurers Pledging to  \nSimplify Prior Authorization  \ne-SUBSCRIBE Today! Don’t miss the latest updates!  \nFEATURE ARTICLES  \nAnnual Fee Schedule Update Will Occur on Sept. 1, 2025  \n2025 Mid-Year Preventive Schedule  \nShort Takes: Claims Guidance, Retro Auth Requests, and More  \nBuilding Value for Well-Child Visits: How to Talk to Parents  \nHOME ABOUT THIS NEWSLETTER CONTACT US LEGAL INFORMATION ARCHIVE AVAILITY PROVIDER RESOURCE CENTER   \n© 2025 Highmark Blue Cross Blue Shield 1  \nA newsletter for the Highmark Blue Cross Blue Shield providers in western New York  \nIssue 6, June 2025  \nIN THIS ISSUE  \nIN THIS ISSUE  \n\n| \u003Cbr>TOP STORY\u003Cbr>Highmark Among Insurers Pledging to Simplify Prior Authorization\u003Cbr>\u003Cbr>AUTHORIZATION\u003Cbr>Expedited Review for RadCard and MSKAuth Requests\u003Cbr>\u003Cbr>REIMBURSEMENT, CLAIMS & BILLING\u003Cbr>Annual Fee Schedule Update Will Occur on Sept. 1, 2025 |\n| --- |\n| New and Updated Reimbursement Policies |\n\nShort Takes: Claims Guidance, Retro Auth Requests, and More  \n\n| \u003Cbr>PREVENTIVE\u003Cbr>2025 Mid-Year Preventive Schedule\u003Cbr>\u003Cbr>PROVIDER SUPPORT\u003Cbr>Building Value for Well-Child Visits: How to Talk to Parents |\n| --- |\n| Virtual Joint Health: Relieving Pain, Restoring Life |\n| Key FAQs: Medicare Compliance Training\u003Cbr>\u003Cbr>ADMINISTRATIVE NEWS\u003Cbr>Accessibility Standards: Ease of Scheduling an Appointment at Your Practice |\n| Is Your Provider Directory Information Still Accurate? |\n\nStaying Up to Date with the Highmark Provider Manual  \nJoin Our Mailing List  \nStay informed and never miss out on what matters!  \nA newsletter for the Highmark Blue Cross Blue Shield providers in western New York  \nIssue 6, June 2025  \nIN THIS ISSUE  \nHighmark Among Insurers Pledging to  \nSimplify Prior Authorization  \nHighmark is committed to improving the prior authorization process, recently joining nearly  \n50 health plans in a national effort  to streamline and simplify requirements.  \n“My belief is that we should be a conduit to appropriate care between the provider and the patient, not the roadblock that everyone thinks weare,” said Chief Medical Officer Dr. Timothy Law, a practicing physician.  \nHighmark has been focused on improvements, with recent successes including:  \n• Decreasing turnaround time for urgent and non-urgent case requests from approximately five days to one day, on average.  \n• Increasing electronic submission of prior authorization requests to over 75% in the last two quarters.  \n• Increasing automation of authorizations at the point of submission from 2% to more than 45%.  \nTechnology Enhancements for Providers  \nOver the past few years, Highmark has invested significantly in technology to reduce administrative burden and simplify workflows for providers.  \n• Availity Essentials® : Transitioned to this multipayer platform to streamline payer-provider transactions.  \n• Electronic Retrospective Review : Launched an electronic process for retrospective claim review, eliminating mail-in requests.  \n• EMR (Electronic Medical Record) Integration:  \nImplementing technology to deliver information directly within providers' EMR systems, reducing reliance on portals, faxes, and phone calls.  \n• Availity Authorizations & Referrals: Leveraging more of Availity’s streamlined authorization process to enhance the experience.  \n• Expedited Review for RadCard and MSK : Providers may be asked for additional information to assist with quicker decisions regarding the request.  \nGold Card Program  \nHighmark's Gold Card program  expedites prior authorization for over 23,000 clinicians who have a proven record of adhering to clinical criteria. Highmark also offers an \"active gold carding\" program to help provider groups improve their care practices and qualify for Gold Card status.  \nHighmark remains committed to improving prior authorization processes and systems to ensure our members get medicall","cbCairvU4D8VD84w","https://ap.wps.com/l/cbCairvU4D8VD84w","pdf",1903541,20,"English","# Highmark Among Insurers Pledging to Simplify Prior Authorization\n## Expedited Review for RadCard and MSKAuth Requests\n## Annual Fee Schedule Update Will Occur on Sept. 1, 2025\n## 2025 Mid-Year Preventive Schedule\n## Building Value for Well-Child Visits: How to Talk to Parents\n## Short Takes: Claims Guidance, Retro Auth Requests, and More\n## Accessibility Standards: Ease of Scheduling an Appointment at Your Practice\n## Is Your Provider Directory Information Still Accurate?\n## Staying Up to Date with the Highmark Provider Manual","[{\"question\":\"What changes are being made to simplify prior authorization requirements?\",\"answer\":\"Highmark joined nearly 50 health plans to streamline and simplify prior authorization requirements. The newsletter also cites process improvements such as reduced turnaround time and increased electronic submission and automation.\"},{\"question\":\"When will expedited review begin for RadCard and MSKAuth authorization requests?\",\"answer\":\"The enhanced submission process for RadCard and MSK authorization requests is effective Sept. 20, 2025, and providers may be asked for additional information to support quicker decisions.\"},{\"question\":\"When does the annual fee schedule update take effect?\",\"answer\":\"The annual fee schedule update for Commercial products in New York regions takes effect on Sept. 1, 2025.\"}]","Highmark Provider Newsletter - Issue 6 - June 2025 | PDF",7]