Blue Cross and Blue Shield of New Mexico (BCBSNM) Medicaid Utilization Review works proactively with the provider community to ensure a clear understanding of the utilization review process by holding statewide provider training sessions. These sessions take place in Farmington, Roswell, Las Cruces, Albuquerque, and Santa Fe.
Provider training sessions are collaborated with ACS and are held twice a year, usually in the spring and fall. Each session is updated with the most current information to keep you informed. These sessions are free of charge.
The BCBSNM sessions are designed for clinicians and other office staff who file prior authorization requests. A session specifically for HCBS Waiver case managers is included.
Medicaid UR staff are the trainers and we are available to interact with the providers and stakeholders.
Topics of the training sessions include beginning basics for BCBSNM flow, timelines, basic requirements and completeness of the requests, contact information, customer service, forms, review process, data entry, avoidance of buck-backs, Waiver ARAs, coding/level of care issues, communications, and the appeal process.
Specific review training is also held in small groups at BCBSNM in Albuquerque once a month or as needed. These sessions are designed to help you with questions you might have on a specific reviews such as long-term care.
Summer Schedule 2008 – Training sessions may be conducted via Webcast
• May 1, 2008 – 10:00 a.m. through 12:00 p.m.
• June 5, 2008 – 10:00 a.m. through 12:00 p.m.
• July 3, 2008 – 10:00 a.m. through 12:00 p.m
• August 7, 2008 – 10:00 a.m. through 12:00 p.m
Please call Customer Service at 1-800-392-9019 to schedule a session.
For your convenience we have provided the 2008 provider training presentations for you to use as a reference.
- Provider Training 2008
- DD Waiver
- D&E Waiver
- The Appeals Process
- Nursing Facility Services
- Emergency Medical Services for Aliens
- Physical, Occupational, and Speech Therapies
- What's New at MUR
