Bcbsnm provider phone number. Where to Go for Answers. This is known as your provider network. Choose my contact preferences. Your health plan works with a group of doctors, specialists and health care facilities. 2020 Medicare Provider Training. Find the information you need to contact BCBSNM. We also will mail you a printed copy of your plan’s provider directory, if preferred. 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. If you are hearing or speech impaired, call 1-877-486-2048. 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. 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 . Blue Cross Blue Shield of New Mexico is committed to giving health care providers the support and assistance they need. You may need to contact your clearinghouse if they use a different BCBSNM payer ID. If you have coverage through your employer, please see “Group Plans” below. Box 27630 Albuquerque, NM 87125-7630 505-291-3500 800-835-8699. These providers are contracted with BCBSNM to provide medical services to members. 1 – CONTACT LIST FOR IN-NETWORK PROVIDERS . Claims/Customer Service. Members should call the number on the back of their BCBSNM member ID card. Web www. 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. Note: A BCBSNM provider record does not automatically activate the NM network. bcbsnm. For more information about submitting claims, refer to Section 8, Claims Submission in our Provider Reference Manual. For other important phone numbers, contact us. Altruista Health’s GuidingCare TM Portal via Availity ® Provider Portal. availity. 0718_NM_Medicaid_Contact List for Providers_Provider_Card. This change supports an improved provider onboarding experience with BCBSNM. 4 days ago · Log in to your account to get the most accurate, personalized search results based on your plan. Learn how to use Availity, HealthXnet, and other online tools for eligibility, benefits, prior authorization, and more. If your provider needs to contact us, they may call the BCBSNM Provider Services Unit at 1-800-693-0663. Call 1-800-MEDICARE (1-800-633-4227) 24 hours a day, 7 days a week. Except in an emergency, this plan does not cover care received from out-of-network providers. For help with these documents, please call 1-877-774-8592. 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. Prescription Inquiries 1-800-423-1973. O. Provider Network Representative Related Service Areas 5701 Balloon Fiesta Parkway • Albuquerque, New Mexico 87113 • 1-800-567-8540 • www. Fax Numbers: Case Management 505-816-3861; Disease All electronic claims submitted to BCBSNM must be routed with payer ID 00790. Not all prescription drug benefit plans include the PA/ST program, and the drug categories may vary depending on the member's plan. 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. 0718 2049551_481366. com . Provider Customer Service Numbers. ANSI Version 5010; New Mexico Provider Grievance Plan For behavioral health services, call 888-898-0070 for authorizations, benefits, and eligibility information. Don’t have an account? Provider Finder ®. Are You a Provider? Contact Customer Service at 1-800-245-1609. 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. 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 . The program helps members access their behavioral health benefits and improves coordination of care between medical and behavioral health providers. Blue Cross Blue Shield of New Mexico Medical Care Management P. . 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. CST, M–F. 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. New Application: HOME LEGAL AND PRIVACY NON-DISCRIMINATION NOTICE CONTACT US 1-800-567-8540. Network Services Contacts Blue Cross Blue Shield of New Mexico is committed to giving health care providers the support and assistance they need. 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. Ancillary Service Center For ancillary product support, submit an online inquiry or call 1-877-723-5697. com Registration Required May 11, 2023 · This page may have documents that can’t be read by screen reader software. ) 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. 1-1 . BCBSNM members should call us at the customer service numbers listed on their member ID cards for 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. Get Answers. , CT; and 9 a. Blue Cross and Blue Shield of New Mexico (BCBSNM) has been in our community for 84 years. 2019 Commercial and Medicare Plans Provider Training. Printable format for BCBSTX Medicaid Contact List for Provider. We'll help you find new providers or check and see if your current providers are in our network. PLEASE USE CHROME BROWSER TO COMPLETE FORM. Box 27630 • Albuquerque, New Mexico 87125-7630 •1-800-567-8540 • www. Box 660738 Dallas, TX 75266-0738: Medical Management Correspondence for Exchange Members: 855-462-1781. Forgot user name or password. to 5:00 p. 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. com. Carelon Provider Portal. Blue Cross and Blue Shield of New Mexico Contact Us. You must use in-network providers. Providers in Your Network. Refer to Section 12, Behavioral Health Services, of the BCBSNM Provider Reference Manual. 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. 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. Find phone numbers, email addresses, and fax numbers for various provider services and units at BCBSNM. Blue Cross and Blue Shield of New Mexico P. BCBSNM utilizes CAHPS ® (Consumer Assessment of Healthcare Providers and Systems) to gauge member experience. Search for a doctor by name, location or specialty to find a doctor in your area to meet your health care needs. Box 660058, Dallas, TX 75266-0058. Reimbursement Calculations; Medical Policy; Medical Policy or Prior Authorization (Out of Area) Affordable Care Act (ACA) ICD-10. Start with a search. With a BAM account, BCBSNM members have their health plan info, all in one place. The online directory tool allows you to easily download, print and/or share the health care provider information via email. m. to 6 p. 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. 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. Cost estimates. Annual Provider Training is a requirement for all Medicaid providers. Check Your Provider Network. Box 660738 Dallas, TX 75266-0738. 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. You’ll see details that may help you lower health care costs. The appearance of a benefit product logo is not a guarantee of payment. Eligibility, Benefits, Provider Network Referral, Claim Status: STAR, CHIP: 1-877-560-8055 STAR Kids: 1-877-784-6802 8:00 a. Provider Enrollment. 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. Explore tools designed to help health care providers conduct research and simplify billing. 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. Fax: 866-589-8254. Program Criteria Summaries and Request Forms BCBSNM will add you to its CAQH provider roster upon receipt of a signed contract. Search for doctors, dentists, hospitals and other health care providers in the commercial networks. 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. For group-level assistance, producer can email us. 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). 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. 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. Doctor reviews and ratings. Explore our new Claims and Eligibility page for everything you need to know about claims. Before you see a doctor, search our providers to see the doctors and hospitals in your provider network. If you choose to see a doctor who is not part of our network, you will have to pay for the services. O. Doctors in your plan network *. gov Blue Cross and Blue Shield of New Mexico (BCBSNM) has been in our community for 84 years. 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. 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. medicare. If there are questions regarding prescription benefit coverage, please call the phone number on the back of the member's BCBSNM ID card. Improve operational efficiency and turnaround time on claims by using electronic transactions for billing, payments, eligibility, and claim status. Log in for optimal results. In-network providers will be paid at their contracted rate. 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. 3 days ago · Contact Us. If you are interested in contracting with BCBSNM please contact us at 505-837-8800 or 1-800-567-8540. Contact us at 1-877-774-8592 (TTY 711). Annual Provider Training. 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 . A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association . 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. Highlights of how our work makes an impact for our members, customers, employees and communities across New Mexico. 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. Group Membership and Eligibility Inquiries 1-855-346-2015 Effective Feb. Get phone numbers and addresses for Medicare, provider, group, individual and family. 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 ). BCBSNM Claim Review Section P. Blues Provider ReferenceManual 1 – Contact . Mailing Address for Express Mailing Services only (UPS, FedEx, etc. Rev 12/2021 P. 1, 2024, BCBSNM is implementing parallel credentialing and contracting processes. 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. Under 65 Customer Service. 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 . Out-of-network providers will be paid the Medicare-allowed amount less any member cost-sharing. Claims will be processed out-of-network, until the provider has applied for network participation, been approved and activated in the network. www. Carelon Contact Center – 866-455-8415 (Monday through Friday, 6 a. enwqtxyvuplivfmdlzsyuibvzynpxqwozntqcfwbilyslqfjbpu