MLO

BCBS Prefix MLO

Highmark Blue Cross Blue Shield of Western New York

New York • Traditional Indemnity, PPO, Medicaid

Billing essentials

Provider phone
(800) 547-3627
Electronic payer ID
SB430
Claims mailing address
P.O. Box 15013, Albany, NY 12212
Timely filing limit
90 daysCompare all plans
Prior authorization phone
(800) 547-3627

Coverage under prefix MLO

Traditional Indemnity

Traditional indemnity coverage under this prefix is a fee-for-service plan. Members can see any provider without network restrictions or referral requirements. The plan reimburses a set percentage of usual and customary charges. Claims are submitted directly to the payer listed above.

PPO

PPO (Preferred Provider Organization) plans allow members to visit any healthcare provider without a referral. In-network providers cost less, but out-of-network care is still covered at a reduced rate. When billing for a PPO plan, submit claims directly to the payer listed above. No referral documentation is needed.

Medicaid

Medicaid managed care under this BCBS prefix means the state has contracted with this plan to administer Medicaid benefits. Balance billing Medicaid members is prohibited. Timely filing requirements may follow state Medicaid rules rather than the plan's commercial deadlines. Contact the plan to confirm submission requirements.

About Highmark Blue Cross Blue Shield of Western New York

Highmark Western and Northeastern New York Inc. providing commercial, Medicare and Medicaid plans in Western New York region.