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 BlueCross BlueShield of Western New York (BlueCross BlueShield), 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

BlueCross BlueShield 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?

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

Updates to AIM Clinical Appropriateness Guidelines for Advanced Imaging

BlueCross BlueShield of Western New York partners with Amerigroup companies to administer certain services to Medicaid Managed Care (MMC) and Child Health Plus (CHPlus) members.

 

Rituxan Biosimilars Medical Step Therapy Notice

January 1, 2021, the following specialty pharmacy drugs and corresponding codes from current Clinical Criteria will be included in our medical step therapy precertification review process.

 

Updates to AIM Clinical Appropriateness Guidelines for Radiation Oncology

BlueCross BlueShield of Western New York partners with Amerigroup companies to administer certain services to Medicaid Managed Care (MMC) and Child Health Plus (CHPlus) members. Updates will apply to the AIM Specialty Health* Clinical Appropriateness Guidelines for Radiation Oncology.

 

Billing guidance for reporting newborn birth weights

BlueCross BlueShield of Western New York (BlueCross BlueShield) partners with Amerigroup companies to administer certain services to Medicaid Managed Care (MMC) and Child Health Plus (CHPlus) members.
 

Update: Notice of changes to the AIM Musculoskeletal Program

Effective November 1, 2020, according to the AIM Level of Care guideline, it is generally appropriate to perform joint codes (CPT® codes 27130, 29871, 29892) and four spine codes (CPT codes 22633, 22634, 63265 and 63267) in a hospital outpatient setting.

 

Featured resources

Pharmacy Information

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

Maternal child program

We offer a proactive case management program for expectant mothers and their newborns. The My Advocate™ program provides pregnant women with proactive outreach and education through interactive voice response (IVR), text or smartphone application.

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 BlueCross BlueShield network?

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