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