Quick Links:

Advanced Imaging and Cardiology Services Program

Effective January 1, 2024, Highmark Blue Shield (NENY) began the utilization management of advanced imaging and cardiology services.

Prior authorization requirements for advanced imaging and cardiology services are applicable to all Highmark Blue Shield (NENY) plans, including:

  • Commercial
  • Medicare Advantage (MA)
  • Affordable Care Act (ACA)
  • Federal Employee Program (FEP)
  • Administrative Services Only (ASO)

These prior authorization requirements are subject to the member’s benefit plan.

The medical policies listed here were established and became effective January 1, 2024. 

Last updated on 4/24/2024 3:49:06 PM

 

To Top

Contact Us

Provider Directory

Site Map

Legal Information

The following entities, which serve the noted regions, are independent licensees of the Blue Cross Blue Shield Association: Western and Northeastern PA: Highmark Inc. d/b/a Highmark Blue Cross Blue Shield, Highmark Choice Company, Highmark Health Insurance Company, Highmark Coverage Advantage Inc., Highmark Benefits Group Inc., First Priority Health, First Priority Life or Highmark Senior Health Company. Central and Southeastern PA: Highmark Inc. d/b/a Highmark Blue Shield, Highmark Benefits Group Inc., Highmark Health Insurance Company, Highmark Choice Company or Highmark Senior Health Company. Delaware: Highmark BCBSD Inc. d/b/a Highmark Blue Cross Blue Shield. West Virginia: Highmark West Virginia Inc. d/b/a Highmark Blue Cross Blue Shield, Highmark Health Insurance Company or Highmark Senior Solutions Company. Western NY: Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Cross Blue Shield. Northeastern NY: Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Shield.

All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration and/or to one or more of its affiliated Blue companies.