Highmark BCBSWNY is closely monitoring COVID-19 developments and how the novel coronavirus will impact our customers and provider partners.COVID-19 information
Availity access
The Availity Portal offers health care professionals free access to real-time information and instant responses in a consistent format regardless of the payer.
At Availity, you can:
Request authorizations
Submit claims
Confirm eligibility
Don’t have an Availity account?
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.
The latest articles and announcements on claims filings, products, benefits, administrative updates, new and revised procedures and
guidelines, prescription information, and more. 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.Provider news
Provider updates
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.
Featured resources
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)
Interested in becoming a provider in the Highmark BCBSWNY network?
We look forward to working with you to provide quality service for our members.
A doctor who cares for one area of the body like a cardiologist
(heart doctor) and oncologist (cancer doctor).
Any place you can get health care that isn’t
a doctor’s office, like a hospital or clinic.
- Primary care provider (PCP)
- Specialist
- Hospital
- Facility
- Behavioral health
- Laboratory
- Urgent care
Find a Doctor
Provider Directories
- Highmark BCBSWNY Provider Directory
Provider education and training
You can get more information about the providers in our health plan. Visit docinfo.org to search for providers and find out where they went to medical school.
Behavioral Health Care
You do not need to see your primary care provider (PCP) before getting behavioral health services. If you need help finding mental health and substance use services, call Member Services or the 24/7 NurseLine at 1-866-231-0847 (TTY 711) Monday through Friday from 8:30 a.m. to 6 p.m. Eastern time. If you think you are in danger of harming yourself or others, call 911 or go the nearest emergency room.
Can’t get to your doctor? Use LiveHealth Online
Visit a doctor 24/7 through live video using LiveHealth Online. All you need is your smartphone, tablet or computer. Sign up or log in to get started.
Pharmacy benefits in Western New York are managed by IngenioRx.
Find a pharmacy
Pharmacy Member Services: 1-833-232-1713 (TTY 711)
Help for pharmacists: 1-833-252-0328
Highmark BCBSWNY members receive routine vision services.
You don’t need a referral for vision care.
To find a vision doctor, use our online provider directory to locate a local eye doctor near you. You can also call Member Services at 1-866-231-0847 for help finding a local eye doctor in your plan.
Dental benefits are provided through Liberty Dental. To find a dentist, go to the Liberty Dental website.
Member questions: 1-866-231-0847 (TTY 711), Monday through Friday, 8:30 a.m. to 6 p.m. Eastern time.
Highmark BCBSWNY members can call Liberty Dental at 1-833-276-0846 (TTY 1-877-855-8039) Monday through Friday, 8 a.m. to 8 p.m. Eastern time to find or change your dentist. Or go to the Liberty Dental website.