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COVID-19 information

Highmark BCBSWNY is closely monitoring COVID-19 developments and how the novel coronavirus will impact our customers and provider partners.

Receive email from Highmark BCBSWNY

Highmark BCBSWNY is now sending some bulletins, policy change notifications, prior authorization update information, educational opportunities and more to providers via email.

Provider news

The latest articles and announcements on claims filings, products, benefits, administrative updates, new and revised procedures and guidelines, prescription information, and more.

Provider updates

Policy Clarification for Practitioner Dispensing

New York State Education (NYSED) Law, Article 137 §6807, authorizes practitioners, who are authorized to prescribe, to dispense medications directly to their patients. This dispensing must be done in accordance with federal, State, and New York State (NYS) Medicaid program policies for dispensing, billing, and record keeping.

• Policy Clarification for Practitioner Dispensing

PrEP Awareness Week October 24 through October 31, 2022

October 24 through October 31, 2022, is PrEP Awareness Week in New York. Highmark BCBSWNY wants to put a highlight on PrEP (pre-exposure prophylaxis) resources now and going forward available to clinicians by New York State Department of Health.

• PrEP Aware Week October 24 through October 31, 2022

Annual Primary Care Provider Audit

Quality Management department is conducting an annual medical record review for documentation standards specific to the MMC and CHPlus programs only.

• Annual Primary Care Provider Audit

9/1/22 Medicaid Enrollment Requirement Notice

Effective September 1, 2022, Highmark Blue Cross Blue Shield of Western New York members must use providers (e.g., pharmacies, providers, and specialists) enrolled with the NYS Medicaid program.

• 9/1/22 Medicaid Enrollment Requirement Notice

Tell us how we’re doing

Rate Our Performance. This information would assist the Network Relations Department in areas of success and improvement.

Pharmacy Information

Search for up-to-date drug information, including hundreds of brand-name and generic medications.

Maternal child program

When it comes to our pregnant members, we are committed to keeping both mom and baby healthy. We encourage all our moms-to-be to take part in the New Baby, New LifeSM program, a comprehensive, proactive case management and care coordination program for all expectant mothers and their newborns.

Behavioral health provider

We work collaboratively with hospitals, group practices and independent behavioral health care providers, community and government agencies, human service districts, and other resources to meet the needs of members with mental health, substance use, and intellectual and developmental disabilities.

Provider tools and resources

• Log in to Availity
• Learn about Availity
• Precertification lookup tool
• Precertification requirements
• Claims overview
• Member eligibility & pharmacy overview
• Provider manual and guides
• Referrals
• Forms
• Training Academy
• Pharmacy information
• Electronic Data Interchange (EDI)