Provider Credentialing Process
How do Providers Become Part of Our Network?
Thank you for your interest in becoming a participating provider with Highmark Blue Cross Blue Shield of Western New York. We value your business and strive to provide quality service to our providers and members.
Providers can enroll in our health plan by completing the Universal Credentialing Application with CAQH, the Council for Affordable Quality Health Care.
How it Works:
Follow this link to access the Universal Provider DataSource
- Under Providers, click 'Go to the Universal Provider Datasource' and login.
- Enter your CAQH Provider ID (if you don't know it, call CAQH at 1-888-599-1771).
- Enter or update your information.
- Authorize Blue Cross Blue Shield WNY to access your information electronically.
Complete the form below and return to the fax number provided.
The CAQH Universal Credentialing Application is our data source for recredentialing. As such, it is important that you keep your information on CAQH current. Update your CAQH application regularly with license(s), malpractice, demographic information, disclosure questions and attest to the accuracy of the information in the application.
Enumeration for Advanced Practice Providers (APPs)
Beginning January 1, 2022, Advanced Practice Providers (APPs) will no longer be required to be fully credentialed with us. As we affiliate with Highmark, APPs will be required to complete a simple online enumeration form within Highmark’s systems. Click here for additional information. Please click the link below to access the enumeration form.
Meet our Provider Network Operations team and find a team member in your territory.
Provider Experience Team
Our Provider Experience team will help navigate you through compensation models and provide guidance on supporting programs.
Medicare Advantage Provider Education Attestation
Review the Medicare education documents, and sign the attestation form.
Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Highmark Western and Northeastern New York Inc., serves eight counties in Western New York under the trade name Highmark Blue Cross Blue Shield of Western New York and serves 13 counties in Northeastern New York under the trade name Highmark Blue Shield of Northeastern New York. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration.