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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.

  • Medical Protocol Updates Available Online – April 2022

    April 27, 2022

    We recently reviewed 48 medical protocols. These protocols will be posted online on or before May 1, 2022, and will have an effective date of June 1, 2022, unless otherwise noted. Highmark’s monthly Medical Policy Update Newsletter will be available online on or before April 25, 2022.
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  • Using the Highmark Provider Resource Center (PRC)

    March 29, 2022

    The Highmark PRC is the central source for all provider-related information for patients who have moved onto Highmark’s system. Since our affiliation with Highmark, we’ve been directing you to the PRC in our webpages and email communications. There are many tools and resources on the PRC to answer your questions, help reduce administrative burden and assist with processes related to these patients.
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  • Colorectal Cancer Screening

    March 29, 2022

    Age is one of the most important risk factors for colorectal cancer. In 2021, the U.S. Preventive Services Task Force (USPSTF) updated their colorectal cancer screening recommendations for people of average risk from 50 to 45 years of age. Please speak with your patients who are 45 or older about the importance of colorectal cancer screening and help them determine the right test for them. In this article, you can review screening options and risk factors.
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  • Immunization Schedule Updates for 2022

    March 29, 2022

    The Advisory Committee on Immunization Practices (ACIP) at The Centers for Disease Control and Prevention (CDC) has released updated vaccination schedules. To help you keep your patients healthy, we want to highlight new recommendations for Shingles (Zoster), Pneumonia, and Dengue vaccines. Here, you can also access ACIP vaccination schedules.
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  • NYS Mandate: Billing for Early Intervention Services

    March 29, 2022

    In accordance with a recent New York State mandate beginning January 1, 2022, Highmark Blue Shield of Northeastern New York will no longer pay claims for early intervention services (EIS). In this article, you can find out where to send claims and what to do to request payment.
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  • New Forms for Medical Providers – Available Online Now

    March 29, 2022

    To streamline our provider information management system and comply with the No Surprises Act (NSA) that took effect January 1, 2022, new provider change forms are now available on our provider forms page. Here, you can view these new forms.
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  • 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.
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  • 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.
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  • 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.
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  • 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.
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