BCBS Prefix SKE

Highmark Blue Shield of Northeastern New York

New York • PPO, Medicare Advantage, High-Deductible Health Plan (HDHP)

Billing essentials

Provider phone: (866) 459-4418
Electronic payer ID: SB865
Claims mailing address: P.O. Box 15013, Albany, NY 12212
Timely filing limit: 90 daysCompare all plans
Prior authorization phone: (866) 459-4418
Provider website: https://hnenybs.highmarkprc.com/

Coverage under prefix SKE

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.

Medicare Advantage

This prefix includes Medicare Advantage coverage. MA plans follow CMS guidelines for timely filing (365 days from date of service), which may differ from the commercial plan's deadline. The payer ID for Medicare Advantage claims may differ from the standard commercial payer ID. Verify before submitting.

HDHP

Under this HDHP prefix, the member's plan has a higher deductible than traditional coverage. This affects patient cost-sharing but does not change how claims are submitted or processed. Use the same payer ID, claims address, and filing procedures listed above. Verify the member's remaining deductible before estimating patient responsibility.