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

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

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.

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.

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.

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.

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.