Skip to main content

Blue Bulletin

Highmark Blue Shield of Northeastern 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.

  • New HEDIS Measure: Advanced Care Planning

    March 29, 2022

    Advanced care planning (ACP) has been added as a new HEDIS measure for 2022. You can be reimbursed for having discussions regarding ACP with your Highmark Blue Shield of Northeastern New York Medicare Advantage patients.
    Continue Reading
  • 2022 Population Health Management Programs

    March 29, 2022

    Our 2022 Population Health Management programs help your legacy system Highmark Blue Shield of Northeastern New York patients manage acute or chronic illnesses to achieve better health outcomes. We review each patient’s case and plan benefits and connect them with one of our care managers who will help support your patient’s medical and psychosocial needs while reinforcing your care plan. You will be provided with updates on your patient when appropriate. Program descriptions and clinical practice guidelines are reviewed and updated as necessary at least annually.
    Continue Reading
  • Medical Protocol Updates Available Online – March 2022

    March 29, 2022

    Highmark’s monthly Medical Policy Update Newsletter will be available online on or before March 28. These changes may impact your patients who have moved onto Highmark’s system. Policy updates described in the newsletter will be effective June 27, 2022.
    Continue Reading
  • Working in NaviNet

    February 24, 2022

    NaviNet is an easy-to-use secure online provider portal that consolidates all insurer/provider transactions into one system, helping to reduce some administrative burden for your office. If you aren’t registered with NaviNet yet, your office will need to request access as your patients gradually move onto Highmark’s systems throughout the year. In this article, you can find an overview of NaviNet’s tools, along with links to NaviNet registration and Highmark’s NaviNet User Guide.
    Continue Reading
  • PrEP Guidelines for HIV Prevention

    February 24, 2022

    Studies described in the New York State Department of Health (NYSDOH) Clinical Education initiative’s HIV clinical guidelines show that patients taking PrEP significantly reduce their risk of becoming infected with HIV. We encourage you to speak with your adult and adolescent patients who are at an increased risk of contracting HIV, about the importance of PrEP and HIV prevention. Here, you can view the guidelines and additional resources.
    Continue Reading
  • PCPs Can Earn Incentives for 2022 Annual Wellness Visits

    February 24, 2022

    We want to remind you to start scheduling your eligible Highmark Blue Shield of Northeastern New York Medicare Advantage patients for their 2022 annual wellness visits (AWVs), which will enable you to earn incentives this year. AWVs are an annual Medicare Advantage patient benefit that reset every January 1, and help to ensure positive outcomes and proactive care. In this article, you can find additional information about this benefit, which is free to your Medicare Advantage patients.
    Continue Reading
  • Updated Drug Therapy Guidelines and Coverage for Remicade Biosimilars Available Online - February 2022

    February 24, 2022

    Drug Therapy Guidelines were recently updated for your patients on both the Highmark and legacy systems. Thirty drug therapy guidelines for patients on the legacy systems were added or updated recently by a committee of local physicians, other prescribers, and pharmacists. Highmark’s recently reviewed and approved drug policy guidelines are now available through the Highmark Provider Resource Center.
    Continue Reading
  • Medical Protocol Updates Available Online – February 2022

    February 24, 2022

    We recently reviewed 38 medical protocols. These protocols will be posted online on or before March 1, 2022 and will have an effective date of April 1, 2022, unless otherwise noted. Highmark’s monthly Medical Policy Update Newsletter for patients moved onto Highmark’s system will be available online on or before February 28.
    Continue Reading
  • Patient Care Program: House Calls

    February 24, 2022

    In March 2022, we’re continuing our House Call programs to help you address and close care or quality gaps for your eligible Highmark Blue Shield of Northeastern New York (Highmark BSNENY) patients.
    Continue Reading
  • New Billing Guidance for Behavioral Health Providers

    February 17, 2022

    As part of our affiliation with Highmark, we’ve updated our billing requirements for electronic behavioral health services claims. To avoid claim denials and help you get paid correctly, behavioral health providers must now include the correct taxonomy and performing provider information (when applicable) when submitting 837P electronic claims.
    Continue Reading

Working with Us

Additional Resources

We want to hear from you! Have a topic request for the next Blue Bulletin? Email us

Stay in Touch! Sign up to receive emails for provider news and information