- Bcbsnm provider phone number. Box 27630 Albuquerque, NM 87125-7630 505-291-3500 800-835-8699. Printable format for BCBSTX Medicaid Contact List for Provider. Are You a Provider? Contact Customer Service at 1-800-245-1609. com . Group Membership and Eligibility Inquiries 1-855-346-2015 Effective Feb. Your health plan works with a group of doctors, specialists and health care facilities. Doctor reviews and ratings. This is known as your provider network. O. Fax Numbers: Case Management 505-816-3861; Disease All electronic claims submitted to BCBSNM must be routed with payer ID 00790. The program helps members access their behavioral health benefits and improves coordination of care between medical and behavioral health providers. Refer to How to Join the BCBSNM Provider Networks section This form must be completed by the member and/or provider for any Blue Cross and Blue Shield of New Mexico (BCBSNM) member receiving ongoing behavioral health care with an out-of-network provider. 2020 Medicare Provider Training. NM Uniform Prior Authorization Form : Use for services requiring prior authorization Out-of-network Note: If you see Medicare members or accept Medicare assignment and are willing to bill BCBSNM, you may treat Blue Cross Group Medicare Advantage Open Access (PPO) members. Have questions about your benefits or a claim? If you have questions about any information in your Blue Access for Members account, you can: Jun 17, 2021 · Find a doctor or hospital in New Mexico quickly and easily using the Blue Cross Blue Shield of New Mexico Provider Finder. indd 1 12/3/18 11:57 AM For an overview of the prior authorization process and requirements at BCBSNM, refer to Section 10 of the BCBSNM Provider Reference Manual . Find the information you need to contact BCBSNM. availity. Carelon Provider Portal. Except in an emergency, this plan does not cover care received from out-of-network providers. Claims will be processed out-of-network, until the provider has applied for network participation, been approved and activated in the network. 2019 Commercial and Medicare Plans Provider Training. O. 1, 2024, BCBSNM is implementing parallel credentialing and contracting processes. Network Services Contacts Blue Cross Blue Shield of New Mexico is committed to giving health care providers the support and assistance they need. Dental Customer Service 1-800-367-6401 Apr 23, 2020 · United States List BCBS Provider Phone Number; Alabama: 800-517-6425 (Benefits/Eligibility) 800-327-3994 (PEEHIP) 800-760-6851 (Customer Service) 800-492-8872 (Federal Employee Program) Provider Reference Manual; CAA and Transparency in Coverage; Telemedicine; Clinical Payment and Coding Policies. If your doctor isn’t in your plan’s network but you don’t want to find someone new, you can search for a new plan with a new network. If you are interested in contracting with BCBSNM please contact us at 505-837-8800 or 1-800-567-8540. Explore tools designed to help health care providers conduct research and simplify billing. Prescription Inquiries 1-800-423-1973. BCBSNM members should call us at the customer service numbers listed on their member ID cards for service. These providers are contracted with BCBSNM to provide medical services to members. Blue Cross Blue Shield of New Mexico is committed to giving health care providers the support and assistance they need. Providers in Your Network. BCBSNM utilizes CAHPS ® (Consumer Assessment of Healthcare Providers and Systems) to gauge member experience. Search for doctors, dentists, hospitals and other health care providers in the commercial networks. If you are a member with a question about your coverage, please contact Customer Service or a specific department listed on this page: Individual and Family Plan. to 6 p. Blue Access Internet Help Desk If you need help getting into our secure website, Blue Access for Members SM , call the Help Desk toll-free at 1-888-706-0583 ( TTY: 711 ). Contact us at 1-877-774-8592 (TTY 711). For more information about submitting claims, refer to Section 8, Claims Submission in our Provider Reference Manual. Log in for optimal results. Eligibility and benefits contact your electronic connectivity vendor, Availity or other electronic connectivity vendor or call 1-800-451-0287* Claim status inquiries contact Availity or other electronic connectivity. Mailing Address for Express Mailing Services only (UPS, FedEx, etc. to 5:00 p. Annual Provider Training is a requirement for all Medicaid providers. You may need to contact your clearinghouse if they use a different BCBSNM payer ID. 0718 2049551_481366. Before you see a doctor, search our providers to see the doctors and hospitals in your provider network. Web www. Highlights of how our work makes an impact for our members, customers, employees and communities across New Mexico. Dental providers who can't able to access their account can read the Dental Summary Guide (PDF) to learn how to: Provider Network Representative Related Service Areas . Contact Name Phone / Fax / Email / URL Availity ® Essentials Client Services Obtain eligibility, benefits, authorizations, claim status, Find providers numbers for claims, correspondence, managed care and traditional products and more Contact audience Provider Contacts Physician Services 2019 Commercial and Medicare Plans Provider Training. Ancillary Service Center For ancillary product support, submit an online inquiry or call 1-877-723-5697. Blues Provider ReferenceManual 1 – Contact . com. Eligibility, Benefits, Provider Network Referral, Claim Status: STAR, CHIP: 1-877-560-8055 STAR Kids: 1-877-784-6802 8:00 a. The appearance of a benefit product logo is not a guarantee of payment. For other important phone numbers, contact us. If you have questions related to your application for participation with BCBSNM provider networks, you should contact your local Professional Provider Network office for assistance. Provider Network Representative Related Service Areas 5701 Balloon Fiesta Parkway • Albuquerque, New Mexico 87113 • 1-800-567-8540 • www. 1-1 . Blue Cross Blue Shield of New Mexico Medical Care Management P. Provider Customer Service Numbers. Call 1-800-MEDICARE (1-800-633-4227) 24 hours a day, 7 days a week. Cost estimates. Find phone numbers, email addresses, and fax numbers for various provider services and units at BCBSNM. In-network providers will be paid at their contracted rate. to noon, CT on weekends and holidays) Participating providers are requested to submit claims within 90 days of the date of service, using the standard CMS-1500 or UB-04 claim form, or electronically. Choose my contact preferences. Box 27630 • Albuquerque, New Mexico 87125-7630 •1-800-567-8540 • www. This change supports an improved provider onboarding experience with BCBSNM. Medicaid Prior authorization: To obtain prior authorization for services for Medicaid members, please use the form found under prior authorization Requirements on the Medicaid webpage . Improve operational efficiency and turnaround time on claims by using electronic transactions for billing, payments, eligibility, and claim status. Start with a search. Under 65 Customer Service. Health care providers, find a Blue Cross NC phone number for info on eligibility, benefits and claims status, plus medical policies, contract updates and more. BCBSNM Claim Review Section P. ANSI Version 5010; New Mexico Provider Grievance Plan For behavioral health services, call 888-898-0070 for authorizations, benefits, and eligibility information. CST, M–F. Claim adjustments call 800-451-0287* For an overview of the prior authorization process and requirements at BCBSNM, refer to Section 10 of the BCBSNM Provider Reference Manual . PLEASE USE CHROME BROWSER TO COMPLETE FORM. Don’t have an account? Provider Finder ®. For help with these documents, please call 1-877-774-8592. Get phone numbers and addresses for Medicare, provider, group, individual and family. 1 – CONTACT LIST FOR IN-NETWORK PROVIDERS . Fax Numbers: Case Management 505-816-3861; Disease You can contact Medicare for more information about Medicare benefits and services, including general information about Medicare Advantage Prescription Drug coverage. Where to Go for Answers. Explore our new Claims and Eligibility page for everything you need to know about claims. Box 660738 Dallas, TX 75266-0738: Medical Management Correspondence for Exchange Members: 855-462-1781. Members should call the number on the back of their BCBSNM member ID card. medicare. Program Criteria Summaries and Request Forms BCBSNM will add you to its CAQH provider roster upon receipt of a signed contract. Forgot user name or password. Fax Numbers: Case Management 505-816-3861; Disease Otherwise, you may end up having to change providers or pay more out of your own pocket. com Registration Required May 11, 2023 · This page may have documents that can’t be read by screen reader software. Find a Doctor or Hospital; For costs and complete details of the coverage, call BCBSNM at 1-866-445-1396 or contact your independent, Blue Cross Blue Shield of New Mexico Medical Care Management P. As one of the largest providers of health benefits in New Mexico, we are pleased to offer this plan for those New Mexicans who qualify. Search for a doctor by name, location or specialty to find a doctor in your area to meet your health care needs. Refer to Section 12, Behavioral Health Services, of the BCBSNM Provider Reference Manual. Fax: 866-589-8254. Annual Provider Training. Check Your Provider Network. We'll help you find new providers or check and see if your current providers are in our network. Reimbursement Calculations; Medical Policy; Medical Policy or Prior Authorization (Out of Area) Affordable Care Act (ACA) ICD-10. You must use in-network providers. 3 days ago · Contact Us. A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association . New Application: HOME LEGAL AND PRIVACY NON-DISCRIMINATION NOTICE CONTACT US 1-800-567-8540. Blue Cross and Blue Shield of New Mexico Contact Us. m. 4 days ago · Log in to your account to get the most accurate, personalized search results based on your plan. Get Answers. 0718_NM_Medicaid_Contact List for Providers_Provider_Card. PROVIDER RESOURCE: Quick Contact List Blue Cross and Blue Shield of New Mexico, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association 481366. Learn how to use Availity, HealthXnet, and other online tools for eligibility, benefits, prior authorization, and more. www. Box 660058, Dallas, TX 75266-0058. For group-level assistance, producer can email us. This integration helps our clinical staff identify members who could benefit from coordination between their medical and behavioral health care and may result in: BCBSNM members should call us at the customer service numbers listed on their member ID cards for service. A provider’s reimbursement is based on a combination of the services covered under the member’s benefit plan in conjunction with a provider’s contract(s) with Blue Cross and Blue Shield of New Mexico (BCBSNM). National Information Center 1 (800) 411-BLUE; Download the fepblue App; If you are interested in contracting with BCBSNM please contact us at 505-837-8800 or 1-800-567-8540. Group Membership and Eligibility Inquiries 1-855-346-2015 Blue Cross and Blue Shield of New Mexico (BCBSNM) has a network of doctors, specialists and hospitals. Blue Cross and Blue Shield of New Mexico, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association BCBSNM Provider One Call Phone (855) 610-9833 Blue Cross Community Centennial Behavioral Health Phone (800) 693-0663 Blue Cross Community Centennial Bilingual (English-Spanish) Dental providers should log in to their secured portal to contact someone for questions about care, payment and claims. You’ll see details that may help you lower health care costs. Claims/Customer Service. Altruista Health’s GuidingCare TM Portal via Availity ® Provider Portal. Blue Cross and Blue Shield of New Mexico (BCBSNM) has been in our community for 84 years. The online directory tool allows you to easily download, print and/or share the health care provider information via email. Altruista Health GuidingCare is a web-based care management tool for assigned providers to monitor rendered services, activities, quality measures and care plans for Blue Cross Community Centennial SM members. Out-of-network providers will be paid the Medicare-allowed amount less any member cost-sharing. If you have coverage through your employer, please see “Group Plans” below. ) Blue Cross and Blue Shield of New Mexico is dedicated to partnering with providers to help maximize opportunities that improves patient care and the member’s experience with their health plan and their respective providers. Provider Enrollment. . We will now start the credentialing process (subject to complete CAQH credentialing application) at the same time the contract is sent to the provider to sign. We also will mail you a printed copy of your plan’s provider directory, if preferred. gov Blue Cross and Blue Shield of New Mexico (BCBSNM) has been in our community for 84 years. If there are questions regarding prescription benefit coverage, please call the phone number on the back of the member's BCBSNM ID card. If you are hearing or speech impaired, call 1-877-486-2048. Rev 12/2021 P. If your provider needs to contact us, they may call the BCBSNM Provider Services Unit at 1-800-693-0663. Our provider network representatives serve as the liaison between BCBSNM and our independently contracted provider community, developing and maintaining cooperative working relationships with our physicians and other health 1. Not all prescription drug benefit plans include the PA/ST program, and the drug categories may vary depending on the member's plan. Note: A BCBSNM provider record does not automatically activate the NM network. For urgent requests concerning an Individual and Family health plan member, please call 800-447-7828 (TTY/TDD: 711) or fax your request to 918-551-2011. If you choose to see a doctor who is not part of our network, you will have to pay for the services. Blue Cross and Blue Shield of New Mexico P. Carelon Contact Center – 866-455-8415 (Monday through Friday, 6 a. With a BAM account, BCBSNM members have their health plan info, all in one place. Aug 21, 2015 · The phone number on your BCBSNM member ID card; The Blue Access ® Internet Help Desk at 888-706-0583; Representatives are available 24 hours a day, 7 days a week. Doctors in your plan network *. , CT; and 9 a. bcbsnm. The Centers for Medicare & Medicaid Services (CMS) requires all Special Needs Plans (SNPs) to provide an annual training on the Model of Care (MOC) for all providers who provide services to SNP members. Box 660738 Dallas, TX 75266-0738. For government programs claims, if you don’t have online access through a vendor, you may call the below customer service phone number to check claim status or make an adjustment: Medicaid claims – call 800-693-0663 Blue Cross and Blue Shield of New Mexico (BCBSNM) has been in our community for 84 years. xvxwrk vhmvin vdob jtlajh yionqkc gcdjkm qnbe mmzfi nrefmm vzxjtv