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

September 22, 2022

To: All Providers

Our legacy provider website ( will be decommissioned on February 1, 2023. Beginning on that date, visitors will be redirected 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 preparation for this change, we have been linking to the Highmark PRC webpages in our email communications and Blue Bulletin articles over the past year.

Below are a few resources and locations on the PRC you may want to start referencing and bookmarking:

As part of this change, some password-protected materials will be available only through NaviNet. If you have not already registered with NaviNet, please click here to register. In the meantime, the legacy website will be live through January 2023 and you can also expect to continue receiving our monthly Blue Bulletin email newsletter. We will provide additional updates in the upcoming months.

Recent Articles

  • 2023 Medicare Advantage Drug Formulary and Pharmacy Prior Authorization Changes
    Beginning January 1, 2023, some of your Highmark Blue Cross Blue Shield of Western New York (Highmark BCBSWNY) Medicare Advantage patients may be affected by changes to Highmark’s pharmacy drug formulary. In early December, please be on the lookout for letters detailing select formulary changes affecting your Medicare Advantage patients. Medication-related prior authorization requests will be submitted to and reviewed by our Utilization Management (UM) team. In this article, you can review 2023 formulary updates along with information about the Medicare Advantage pharmacy prior authorization review process as all Medicare Advantage members move onto Highmark’s system.
  • Enhancements to NaviNet Prior Authorization Experience
    We will begin rolling out enhancements to our utilization management (UM) tool through NaviNet on January 1, 2023. These enhancements are intended to streamline your experience by enabling faster reviews and greater transparency around the status of your authorization requests. Here, you can find tips for submitting NaviNet authorization requests on the new platform.
  • Prior Authorization Changes Postponed for Musculoskeletal Procedures and Pain Management, Molecular and Genomic Testing, and Radiation Oncology
    We are postponing the authorization requirement changes for some musculoskeletal (MSK) procedures and interventional pain management, molecular and genomic testing, and radiation oncology services that we announced last month. The requirement updates, which will be managed by eviCore, will not take effect until late Q1 or early Q2. Webinars will be scheduled to orient providers to the eviCore programs before they take effect.
  • Reimbursement Reduction for Cassette-Based X-Ray Imaging
    Effective February 27, 2023, the reduction applied to the reimbursement for X-ray services using computerized radiography cassette-based imaging (FY modifier) is increasing from 7% to 10% (3% additional reduction) for your Highmark Blue Cross Blue Shield of Western New York commercial and Medicare Advantage patients. In this article, you can access the updated reimbursement policy.
  • Two Injectables to Require Prior Authorization Beginning March 1
    On March 1, 2023, two injectable drugs will require prior authorization. Here, you can view the codes as well as additional information about prior authorizations.

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