1. Highmark BCBS/Highmark BS
  2. Adaptive Form Title
  4. Delete Trading Partner
  5. Adaptive Form Footer
Highmark BCBS and Highmark BS Logos

 EDI Application to Delete Trading Partner

All fields with (*) are required

Select the tabs on the left to fill out the information in those sections

Requester Information (Must be the Trading Partner Administrator)

Trading Partner Information

Additional Comments

The following entities, which serve the noted regions, are independent licensees of the Blue Cross Blue Shield Association:

Western NY:  Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Cross Blue Shield.

Northeastern NY: Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Shield.

All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration and/or to one or more of its affiliated Blue companies.