Provider

Welcome, Providers

News and Updates

Electronic Transactions on Independence Day Holiday Adobe Acrobat PDF 07/03/09
Modifier 59 Exempt Auditing 06/24/09
New Catastrophic Petition Form 06/20/09
Availity Training Webinars for Participating Provider Adobe Acrobat PDF 06/13/09
Not Otherwise Classified J-Codes 06/03/09
Care Comparison Data Collection Form 05/23/09

Electronic Commerce

Overview
Advantages
Alerts
Availity

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Claim Filing

Appeals Process information Adobe Acrobat PDF
CMS-1500 Tutorial
CMS-1500 User Guide Adobe Acrobat PDF
UB04 User Guide Adobe Acrobat PDF

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Pharmacy

Drug List Updates
Drug List - Therapeutic Class with Alphabetic Index Adobe Acrobat PDF
Drug List Limitations, Exclusions, and Prior Authorization Criteria Adobe Acrobat PDF
Rx Drug Prior Authorization Form Adobe Acrobat PDF
Specialty Drug List Adobe Acrobat PDF

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Provider Network

Provider Finder
Network Overview

Provider Tools

Clear Claim Connection
Fraud Awareness Tutorial
Obesity Management Tool Kit Web Site
Hospital Comparison Tool

 

Provider Library

Provider Reference Manual (PRM) and Changes Adobe Acrobat PDF
Medical Policies
Forms
Become a BCBSNM Provider Adobe Acrobat PDF

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UM/QI/Medical Management

• Preventive Care Guidelines: Adult Adobe Acrobat PDF Child Adobe Acrobat PDF
Clinical Practice Guidelines Adobe Acrobat PDF
Preauthorization

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BlueSalud

BlueSalud
Alerts
Contacts Adobe Acrobat PDF

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Medicaid Utilization Review

About Medicaid UR
Training
Review Types

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Blue Medicare PPO

Contacts
Overview
Alerts

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Contact Us

BCBSNM Contact Information for Providers