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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.

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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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  • Vaccine Update: COVID-19 and Monkeypox

    August 30, 2022

    With the ongoing COVID-19 pandemic and rising cases of Monkeypox in New York State, we know one of your top priorities is keeping your patients safe. We’ve outlined information about which vaccines are right for your patients according to the most recent CDC guidelines as well as how to access them.
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  • Updated Claims Adjustment Policy

    August 30, 2022

    We’ve updated our claims adjustment policy. Effective January 1, 2022, you will have 365 days from the date of service or date of discharge (for inpatient claims) to request an adjustment on a claim or to submit any corrections for your legacy and Highmark system patients.
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  • Member ID Card and Billing Reminders

    August 30, 2022

    If a patient’s last name is missing a letter on their member ID card, claims should still be submitted with the patient’s complete first and last name. Here, you can also view helpful billing reminders and claims submission guidance.
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  • Medical Protocol Updates Available Online – August 2022

    August 30, 2022

    We recently reviewed several medical protocols. These will be posted online on or before September 1, 2022, and will have an effective date of October 1, 2022, unless otherwise noted. Highmark’s monthly Medical Policy Update Newsletter will be available online on or before August 29.
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  • Updated Drug Therapy Guidelines Available Online - August 2022

    August 30, 2022

    Drug Therapy Guidelines were recently updated for your patients on both the Highmark and legacy systems. Thirty-four (34) drug therapy guidelines were added or updated recently by a committee that includes local physicians, other prescribers, and pharmacists. Highmark’s recently reviewed and approved drug policy guidelines are now available through the Highmark Provider Resource Center.
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  • 2023 Anesthesia Reimbursement Change

    August 23, 2022

    Effective January 1, 2023, our reimbursement policy for anesthesia services will be changing to align with Highmark in accordance with CMS guidance and national standards.
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  • Right Start Prenatal Program Transition for 2023

    August 17, 2022

    Beginning January 1, 2023, Right Start prenatal and home visiting programs for high-risk pregnancies will no longer be continuing for your Highmark Blue Cross Blue Shield of Western New York patients. Your Highmark BCBSWNY patients that are enrolled in Right Start and still need support into 2023 will be transitioned into our High-Risk Maternity Specialty Case Management program.
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