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

Coordination of Benefits Agreement effective March 28, 2022

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.

CPT Category II code reimbursements

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.

Annual primary care provider audit

Well-documented medical records accurately and completely reflect the care provided to a patient. In our commitment to providing a system of quality care, our Quality Management department is conducting an annual medical record review for documentation standards.

2021 Prenatal Audit

The 2021 Prenatal Audit is a comprehensive review of the medical record documentation standards audit as it applies to prenatal and postpartum care.

NYS HPV ECHO Series

A free 4 CE/CME learning series for pediatric and family care providers.

 

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.