Common Provider
Frequently Asked Questions



Print



Provider forms and their descriptions can be found in the Education and Reference/Forms section.


Go to How to join the BCBSNM provider networks where you can find out how to request a provider record, applications to join the network and the credentialing process.


Go to ICD-10 in the Standards and Requirements section where you will find important timelines and requirements, frequently asked questions, webinar schedules, contact information and more.


Visit our Clear Claim Connection* (C3) web page for more information about the tool and how to attend a webinar.


Complete the Electronic Funds Transfer Agreement .

Please see ERA/EFT/EPS FAQs  for answers about electronic claims filing.


Non-contracted providers can use the Request to Establish or Revise a Non-Contracted Facility Record or the Request to Establish or Revise a Non-Contracted Provider Record  located in the Forms section of the Education and Reference Center.

Contracted or non-contracted providers can use the Update Your Contact Information form.

Note: Please allow up to 30 days for changes to take place.


1. Apply online **

2. Apply by mail. Call or email the NPI Enumerator to request an application form. Send the completed application to:

NPI Enumerator
P.O. 6059
Fargo, ND 58108-6059

3. Apply by third party. With your permission, an organization may submit your application in an electronic file. This could mean that a professional association or perhaps a health care provider who is your employer could submit an electronic file containing your information and the information of other health care providers.

Type 1 – Individual

Type 2 – Organizational

Contact Information

Contact Fox Systems directly with questions about processing an NPI application.

Telephone:
1-800-465-3203
1-800-692-2326 (TTY)


Always include the following information on your claims:

  • Member's three-letter alpha prefix and the identification number (e.g. YIF1234567)
  • Policy group number
  • Onset date
  • Physician's and/or supplier's name, address, telephone number
  • Physician's and/or supplier's NPI

View Tips for Preventing Claim Delays Adobe Acrobat PDF


Refer to our preauthorization page for preauthorization and predetermination requirements.


Go to Interactive Voice Response System in the Claims and Eligibility section. There you will find:

  • IVR available hours
  • NPI guidelines
  • IVR claims, eligibility and preauthorization caller guides

 


Resources, forms, contact information, and more, can be found in the Network Participation section.