Filing for Border County Providers

Quick access to our online Provider tools and resources makes it easy to spend more time where it matters most – with your employees.

In this section, you can get the answers you need about Medicare Part D and Creditable Coverage, as well as fast access to a variety of administrative and HIPAA forms.

As always, if you have any questions, simply contact a representative on our sales team.
We’re here to help you sell Blue!

 

 

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Example 1—Provider has contracts with Blue Cross BlueShield of Western New York and Highmark BlueCross BlueShield in Pennsylvania.

  • Claims for a BlueCross BlueShield of Western New York member are filed directly with their plan.
  • All other claims are filed with Highmark BlueCross BlueShield in Pennsylvania.

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Example 2—Provider is located in a Western New York county that borders Pennsylvania but only has a contract with BlueCross BlueShield of Western New York.

  • All claims are filed with BlueCross BlueShield of Western New York.

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Example 3Provider is located in a New York county that borders Pennsylvania but only has a contract with Highmark BlueCross BlueShield in Pennsylvania.

  • When this provider renders a service to a BlueCross BlueShield of Western New York member, the claim is filed with BlueCross BlueShield of Western New York.
  • All other claims are filed with Highmark BlueCross BlueShield in Pennsylvania.

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