Highmark Blue Shield of Northeastern New York
New York • High-Deductible Health Plan (HDHP), EPO, Medicaid
This prefix is associated with a High-Deductible Health Plan. HDHP members pay more out-of-pocket before insurance coverage begins. These plans are commonly paired with HSA or HRA accounts. When billing, be aware that the member may have significant cost-sharing responsibility until their annual deductible is satisfied.
EPO coverage under this prefix means the member must use network providers but does not need referrals for specialist visits. This plan type is becoming more common as it offers lower premiums than PPO plans while providing more flexibility than HMOs. Verify network status before providing services.
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.
Highmark Western and Northeastern New York Inc. providing commercial, Medicare and Medicaid plans in Northeastern New York.