Bluecross Blueshield of Western New York Home

Medicaid & CHP Providers

Welcome, providers!

Resources that help health care professionals do what they do best — care for our members.

At Highmark Blue Cross Blue Shield of Western New York (Highmark BCBSWNY), we value you as a provider in our network. That is why we have designed the provider site to make it more useful for you and easier to use.

Interested in joining our provider network? We look forward to working with you to provide quality services to our members.

COVID-19 information

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

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

Learning opportunities

Find learning opportunities to assist with administering your patient’s health plan using Availity Essentials multi-payer features and payer spaces applications. Use the library of self-paced courses and instructor-led training sessions, available 24/7 at no cost. Be prepared with the knowledge to assist our members.

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.

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

It’s time for some of your patients to renew their Medicaid benefits

As states begin to recommence Medicaid renewals, we want to ensure you have the information needed to help your Medicaid patients renew their healthcare coverage.

Fraud, Waste and Abuse Prevention

Effective March 28, 2023

Under the revised rulemaking in 18 NYCRR Part 521 Fraud, Waste and Abuse Prevention, all NYS required providers shall provide a copy of their annual ETIN Form to the Health Plan for which they are a participating provider. Your ETIN Form contains certification that you have met the requirements of section 363-d of the Social Services Law and this SubPart. A copy of your ETIN Form must be provided upon signing the provider agreement with the Health Plan, and annually thereafter.

You may submit a copy of your ETIN Form to our Compliance Department via e-mail to:

April 2023

Beginning April 1, 2023, all Medicaid members enrolled in Highmark Blue Cross Blue Shield of Western New York (Highmark BCBSWNY) will receive their prescription drugs through NYRx, the Medicaid Pharmacy Program. Information about the transition of the pharmacy benefit from Highmark BCBSWNY to NYRx, the Medicaid Pharmacy Program can be found HERE. General information about NYRx, the Medicaid Pharmacy Program can be found HERE along with information for Members and Providers

Child Health Plus Benefit Expansion

Highmark Blue Cross Blue Shield of Western New York (Highmark BCBSWNY) partners with Amerigroup companies to administer certain services to Medicaid Managed Care (MMC) and Child Health Plus (CHPlus) members. Please note, this information is specific to the MMC and CHPlus programs only.

Pharmacy Billing Guidance (Exceptions for Non-Enrolled Prescribers)

Updates to Pharmacy Billing Guidance for Interns, Residents and Foreign Physicians in training as well as Out-of-State (OOS) Licensed Prescribers who are treating Medicaid Members for a single instance of emergency care within 180 days.


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

Interested in becoming a provider in the Highmark BCBSWNY network?

We look forward to working with you to provide quality service for our members.