Provider News
Provider News is a valuable resource for health care providers who participate in our networks. Published monthly on the last Monday of the month, Provider News conveys important product, policy, and administrative information, including billing, claims, and program updates.
The publication also features the latest news, information, tips, and reminders about our products and services, as well as relevant interviews, articles, and stories, for health care professionals who serve Highmark Blue Shield (NENY) members.
Regular topics include:
- New and Updated Reimbursement Policies
- Authorization Updates
- Staying Up to Date with the Highmark Provider Manual
For medical policy and claims administration updates, including coding guidelines and procedure code revisions, be sure to read Medical Policy Update.
Please e-Subscribe to receive e-mail notification when the latest issue is available online.
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8 Years Old\u003c/li\u003e\n\u003cli\u003eNon-Participating Providers Required to Use Self-Service Tools for Claim Status and Claim Inquiry\u003c/li\u003e\n\u003cli\u003eNew Social Determinants of Health (SDOH) Quality Guide\u003c/li\u003e\n\u003cli\u003eFEP Members Are Getting New ID Cards\u003c/li\u003e\n\u003cli\u003eReminder: Filing Contiguous County Claims for Highmark Members and Non-Highmark Members\u003c/li\u003e\n\u003cli\u003eNew and Updated Reimbursement Policies\u003c/li\u003e\n\u003cli\u003eAuthorization Updates: Out-of-Area Exceptions, MSK Bilateral Reminder, and Sept. 30 Changes\u003c/li\u003e\n\u003cli\u003eDirectory Information \u0026ndash; Here\u0026rsquo;s How to Attest\u003c/li\u003e\n\u003cli\u003eStaying Up to Date with the Highmark Provider Manual\u003c/li\u003e\n\u003c/ul\u003e","longDescription":null,"visible":false,"archive":false,"liveStatus":2},{"id":41860,"versionId":17727,"title":"Issue 7, July 2024","type":2,"subType":null,"childSubType":"","date":"7/29/2024","endDate":null,"additionalDate":null,"imageUrl":"https://content.highmarkprc.com/Files/Region/hbsneny/NewsletterNotices/ProviderNews/2xneny-pn-issue-7-2024.png","url":"https://hnenybs.highmarkprc.com/pnews/pn-7-2024/","baseUrl":null,"urlText":"Read","description":"\u003cul\u003e\n\u003cli\u003eEffective Aug. 1: Self-Service Tools Required for Claim Status and Claim Inquiries\u003c/li\u003e\n\u003cli\u003eHow-To Guide: Using the Claim Status and Claim Inquiry Functions in Availity\u003c/li\u003e\n\u003cli\u003eA Conversation with Jerry Walsh, Senior Vice President of Provider Contracting\u003c/li\u003e\n\u003cli\u003eAnnual Fee Schedule Update Will Occur on Nov. 1, 2024\u003c/li\u003e\n\u003cli\u003eTimely Access to Support: Coding for Optimal Care\u003c/li\u003e\n\u003cli\u003eEncouraging Medicare Patients to Improve Health Outcomes\u003c/li\u003e\n\u003cli\u003eShort Takes: Fee Schedules, Express Scripts, and Spring Health Webinar\u003c/li\u003e\n\u003cli\u003eHEDIS Measure: Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis\u003c/li\u003e\n\u003cli\u003eBehavioral Health: 7 Tips for Authorization Request Approvals\u003c/li\u003e\n\u003cli\u003eAuthorization Updates\u003c/li\u003e\n\u003cli\u003eNew and Updated Reimbursement Policies\u003c/li\u003e\n\u003cli\u003eFormulary Updates\u003c/li\u003e\n\u003cli\u003eDirectory Information \u0026ndash; 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Educating and Screening Patients\u003c/li\u003e\n\u003cli\u003eReference Guide of Highmark Member Programs for 2024\u003c/li\u003e\n\u003cli\u003ePrEP Guidelines for HIV Prevention\u003c/li\u003e\n\u003cli\u003eShort Takes: HEDIS Changes and MP S-123 Update\u003c/li\u003e\n\u003cli\u003eNew and Updated Reimbursement Policies\u003c/li\u003e\n\u003cli\u003eQuarterly Formulary Updates\u003c/li\u003e\n\u003cli\u003eStaying Up to Date with the Highmark Provider Manual\u003c/li\u003e\n\u003cli\u003eDirectory Information \u0026ndash; Here\u0026rsquo;s How to Attest\u003c/li\u003e\n\u003c/ul\u003e","longDescription":null,"visible":false,"archive":false,"liveStatus":2},{"id":41341,"versionId":17727,"title":"Issue 1, January 2024","type":2,"subType":null,"childSubType":"","date":"1/29/2024","endDate":null,"additionalDate":null,"imageUrl":"https://content.highmarkprc.com/Files/Region/hbsneny/NewsletterNotices/ProviderNews/2xneny-pn-issue-1-2024.png","url":"https://hnenybs.highmarkprc.com/pnews/pn-1-2024/","baseUrl":null,"urlText":"Read","description":"\u003cul\u003e\n\u003cli\u003e1 Week to Availity Transition: Preparing for the New Portal\u003c/li\u003e\n\u003cli\u003e2024 Preventive Health Guidelines\u003c/li\u003e\n\u003cli\u003eShort Takes: Legacy Claims Update, New Preventive Vaccines, \u0026amp; Outpatient Speech Therapy\u003c/li\u003e\n\u003cli\u003eNew and Updated Reimbursement Policies\u003c/li\u003e\n\u003cli\u003eAuthorization Updates\u003c/li\u003e\n\u003cli\u003eStaying Up to Date with the Highmark Provider Manual\u003c/li\u003e\n\u003cli\u003eDirectory Information \u0026ndash; Here\u0026rsquo;s How to Attest\u003c/li\u003e\n\u003c/ul\u003e","longDescription":null,"visible":false,"archive":false,"liveStatus":2},{"id":40560,"versionId":17727,"title":"Issue 12, December 2023","type":2,"subType":null,"childSubType":"","date":"12/22/2023","endDate":null,"additionalDate":null,"imageUrl":"https://content.highmarkprc.com/Files/Region/hbsneny/NewsletterNotices/ProviderNews/2xpn-dec-2023-neny.png","url":"https://hnenybs.highmarkprc.com/pnews/pn-12-2023/index.html","baseUrl":null,"urlText":"Read","description":"\u003cul\u003e\n\u003cli\u003eAvaility Update: Countdown to February 5 Transition\u003c/li\u003e\n\u003cli\u003eProfessional Providers Moving to Group Contracts\u003c/li\u003e\n\u003cli\u003eShort Takes: High-Dollar Facility Claims, PaySpan Access Ending in April, 100-Day Supply for Generics\u003c/li\u003e\n\u003cli\u003eNew Clinical Support Programs for 2024\u003c/li\u003e\n\u003cli\u003eJanuary is Cervical Cancer Awareness Month\u003c/li\u003e\n\u003cli\u003eNew York State\u0027s End The Epidemic - HIV/AIDS Plan\u003c/li\u003e\n\u003cli\u003eJanuary Coding Webinar: Acute vs. Chronic Conditions\u003c/li\u003e\n\u003cli\u003eNew and Updated Reimbursement Policies\u003c/li\u003e\n\u003cli\u003eAuthorization Updates\u003c/li\u003e\n\u003cli\u003eQuarterly Formulary Updates\u003c/li\u003e\n\u003cli\u003eStaying Up to Date With the Highmark Provider Manual\u003c/li\u003e\n\u003c/ul\u003e","longDescription":null,"visible":false,"archive":false,"liveStatus":2},{"id":40484,"versionId":17727,"title":"Issue 11, November 2023","type":2,"subType":null,"childSubType":"","date":"11/27/2023","endDate":null,"additionalDate":null,"imageUrl":"https://content.highmarkprc.com/Files/Region/hbsneny/NewsletterNotices/MPU/2xneny-pn-issue-11-2023.png","url":"https://hnenybs.highmarkprc.com/pnews/pn-11-2023/","baseUrl":null,"urlText":"Read","description":"\u003cul\u003e\n\u003cli\u003eAdvanced Imaging and Cardiology: Prior Auth Changes About One Month Away\u003c/li\u003e\n\u003cli\u003eFederal Employee Program: High-Cost Drugs to Require Prior Authorization\u003c/li\u003e\n\u003cli\u003eShort Takes: Moving to Group Contracts, Prior Auth Changes, and More\u003c/li\u003e\n\u003cli\u003eSchool-Based Mental Health Clinics: Coverage Changes in 2024\u003c/li\u003e\n\u003cli\u003eDoctor On Demand Transition January 1\u003c/li\u003e\n\u003cli\u003eNational Influenza Vaccination Week \u0026ndash; 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Date with the Highmark Provider Manual\u003c/li\u003e\n\u003c/ul\u003e","longDescription":null,"visible":false,"archive":false,"liveStatus":2},{"id":40299,"versionId":17727,"title":"Issue 9, September 2023","type":2,"subType":null,"childSubType":"","date":"9/25/2023","endDate":null,"additionalDate":null,"imageUrl":"https://content.highmarkprc.com/Files/Region/hbsneny/NewsletterNotices/ProviderNews/2xneny-pn-issue-9-2023.png","url":"https://hnenybs.highmarkprc.com/pnews/pn-9-2023/","baseUrl":null,"urlText":"Read","description":"\u003cul\u003e\n\u003cli\u003ePhysical Medicine: Prior Authorization Changes Occurring in the New Year\u003c/li\u003e\n\u003cli\u003eAvaility Update: Controlled Deployment Begins October 22\u003c/li\u003e\n\u003cli\u003eShort Takes: RSV Vaccines, Annual Fee Schedule, and More\u003c/li\u003e\n\u003cli\u003eMCG 27th Edition Release\u003c/li\u003e\n\u003cli\u003eBreast Cancer Awareness Month Starts October 1\u003c/li\u003e\n\u003cli\u003eWeight Assessment \u0026amp; 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