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Patients Moving onto Highmark’s System July 1

Date:
May 26, 2022

By July 1, more than 50% of commercial and large group ASO Highmark Blue Shield of Northeastern New York patients will be on Highmark’s system.

NaviNet is an essential resource for checking these patients’ benefits and eligibility, submitting preauthorization requests, viewing explanation of benefits (EOBs), and submitting claims. If you have not already registered for NaviNet, you can do so here.

Provider-related information for patients on Highmark’s system, such as preauthorization forms and requirements, the Highmark Provider Manual, medical policies and reimbursement, and formulary updates can be found on the Highmark Provider Resource Center (PRC).

We encourage you to reference our provider FAQs on our Working Together During the Highmark Affiliation page for the latest updates

For more information and resources, visit the links below:

Recent Articles

  • Right Start Prenatal Program Transition for 2023
    Beginning January 1, 2023, Right Start prenatal and home visiting programs for high-risk pregnancies will no longer be continuing for your Highmark Blue Shield of Northeastern New York patients. Your Highmark BSNENY 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.
  • Improving Patient Satisfaction with CAHPS and HOS Surveys
    The Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Medicare Health Outcomes Survey (HOS) are patient surveys that affect CMS star ratings – for you and for us. Improving patient experience leads to better health outcomes for your patients and helps support gap closure programs. In this article, you can find tips to help your office improve patient satisfaction, as well as additional information about these surveys.
  • Reminder: Working with BetterDoctor
    Highmark Blue Shield of Northeastern New York partnered with BetterDoctor in 2020 to help keep our network provider information current. As part of our network, you can expect to receive emails from BetterDoctor and should not hesitate to respond to their outreach.
  • Congratulations to New York State HPV Vaccination Honor Roll Award Winners
    We want to congratulate several provider offices for achieving superior youth human papillomavirus (HPV) vaccination completion rates in their practice. Despite strong education efforts, youth HPV vaccination rates continue to remain low. According to the NYS HPV Coalition, at least 30% of adolescents in New York State are not fully vaccinated against HPV. Here, you can view the winners and find additional information about HPV vaccination.
  • Diabetes Prevention Program for Medicare Advantage Patients - 2022
    As a reminder, the Medicare Diabetes Prevention Program (M-DPP) is a no-cost program to help your Highmark Blue Shield of Northeastern New York Medicare Advantage patients with prediabetes manage their condition. This evidence-based, CDC-recognized program helps educate and offer support for older adults diagnosed with prediabetes or who are at high risk for developing Type 2 diabetes. In this article, you can learn more about the program and refer your eligible patients.

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