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Blue Bulletin

Highmark Blue Cross Blue Shield of Western New York strives to provide our network of provider practices and facilities with the most current health plan information in a quick and easily accessible manner.

  • Provider Resource Center to Replace Legacy Provider Website on February 1, 2023

    September 22, 2022

    Beginning on February 1, 2023, we will be redirecting those visiting our legacy provider website (bcbswny.com/provider) to the Highmark Provider Resource Center (PRC). The timing of this transition will occur after all Highmark BCBSWNY patients have been moved onto Highmark’s system in January 2023. In this article, you can learn more about this change and how to access important resources on the PRC.
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  • New Phone Self-Service Tools

    September 22, 2022

    To help reduce Provider Service call wait times, we’ve introduced new self-service phone tools. When you call Provider Service at 1-800-950-0051, you will hear new voice prompts to help you access patient information, including claims status, eligibility, and benefits without speaking to a representative.
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  • Virtual CME Opportunities

    September 22, 2022

    As you consider how to complete required Continuing Medical Education (CME) before the end of the year, we are happy to offer some new CME opportunities. You can earn up to 6 CME credits online at no cost through Highmark’s Population Health University and Coding and Quality Knowledge College. In this article, you can register for online modules, as well as an October webinar.
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  • 2023 Vatica Incentive Payment Changes

    September 22, 2022

    Starting January 1, 2023, incentive payments for Vatica Annual Wellness Visits (AWV) will be paid directly from Vatica Health. Payments will be made monthly. This change creates a more streamlined process and eliminates the possibility of incentive payment discrepancies. Here, you can access updated billing grids and view coding guidance.
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  • Utilization Management: Coverage and Denial Processes

    September 22, 2022

    Understanding coverage and denial decisions and knowing the right steps to take after an authorization is denied will help your patient get the right care at the right time. This article provides further guidance on the appeal process after an authorization denial.
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  • Highmark Medical Policy Updates

    September 22, 2022

    Highmark’s monthly Medical Policy Update Newsletter will be available online on or before September 26.
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  • 2023 Preventive Coverage Changes

    September 16, 2022

    Beginning January 1, 2023, we will be aligning with Highmark’s preventive services schedule determined by the USPSTF, AAP Bright Futures, HRSA Women’s Preventive Health, CDC General Immunization Schedule, and CMS Preventive Schedule. This means some labs previously considered preventive with a $0 cost-share for your Highmark Blue Cross Blue Shield of Western New York Commercial and Medicare Advantage patients will now be subject to your patients’ regular cost-shares and deductibles only when the lab is billed with a medical diagnosis.
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  • $0 Cost-Share for Monkeypox Diagnosis, Testing and Vaccine Administration

    September 08, 2022

    Following a recent New York State (NYS) Executive Order, we’re waiving copays, coinsurances and deductibles for the diagnosis and testing of Monkeypox as well as vaccine administration for your Highmark Blue Cross Blue Shield of Western New York (Highmark BCBSWNY) fully-insured Commercial patients.
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  • 2022 Fee Schedule Update

    August 30, 2022

    Our annual fee schedule update will take effect on October 1, 2022. Updates include some incremental increases throughout the fee schedule to align with Highmark’s fee schedules. There are no decreases. Here, you can find out how to access the updated fee schedules on the Highmark Provider Resource Center (PRC) and on our legacy provider dashboard.
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  • Preauthorization Reminders and New Behavioral Health UM Requirements

    August 30, 2022

    As more of your Highmark Blue Cross Blue Shield of Western New York patients move onto Highmark’s system, understanding key preauthorization differences for your legacy and Highmark system patients will help ensure faster processing time and reduced administrative burden. In this article, you can review the preauthorization request process for your patients on Highmark’s system, as well as new preauthorization criteria for inpatient behavioral health services.
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