Skip to main content

Filing for Border County Providers

Quick access to our online Provider tools and resources makes it easy to spend more time where it matters most – with your employees.

In this section, you'll find the answers you need about Medicare Part D and Creditable Coverage, as well as fast access to a variety of administrative and HIPAA forms.

As always, if you have any questions, simply contact a representative on our sales team. We’re here to help you sell Blue!

how border county providers work example 1

Example 1— Provider has contracts with Highmark Blue Shield of Northeastern New York and Blue Cross Blue Shield of Vermont.

  • Claims for a Highmark Blue Shield of Northeastern New York member are filed directly with their plan.
  • All other claims are filed with Blue Cross Blue Shield of Vermont.
how border county providers work example 2

Example 2— Provider is located in a Northeastern New York county that borders Vermont but only has a contract with Highmark Blue Shield of Northeastern New York.

  • All claims are filed with Highmark Blue Shield of Northeastern New York.
how border county providers work example 3

Example 3— Provider is located in a New York county that borders Vermont but only has a contract with Blue Cross Blue Shield of Vermont.

 

  • When this provider renders a service to a Highmark Blue Shield of Northeastern New York member, the claim is filed with Highmark Blue Shield of Northeastern New York.
  • All other claims are filed with Blue Cross Blue Shield of Vermont.