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Registration Is Required For Centennial Care

November 25, 2013

The Human Services Department (HSD) requires any provider who files a New Mexico (NM) Medicaid claim with a Managed Care Organization (MCO) for Centennial Care, and is not currently enrolled as either a Fee for Service (FFS) or Managed Care only provider to register on the NM Medicaid Provider Web Portal .

MCO-only registration is located within the provider enrollment section that includes the Managed Care Organization (MCO) network only option and the Non-network Managed Care Organization (MCO) option. Select one of these options and complete the enrollment process. The following providers must be registered:

  • Solo providers type 1 NPI
  • Groups type 2 NPI (including ancillary, facility, professional, etc.)
  • Individuals within a group
  • Providers with multiple NPI numbers that render services to NM Medicaid members must register each applicable NPI number
  • Atypical providers that are not required to have an NPI but, are required to register (Personal Care Services, Environmental Modification, etc.)


If you have multiple NPI numbers that are utilized to render services to NM Medicaid members, each NPI must be registered. Regardless of participation status with an MCO, the State requires you to be enrolled in order to receive Medicaid reimbursement. Failure to register may result in denial of claims.

If you are already registered, re-registration will not be required. Please ensure that each practitioner in your practice is registered. All enrollment information (changes to demographics, licensure or certification, provider status, etc.) must be updated on the NM Medicaid Provider Web Portal.

Refer to the HSD Frequently Asked Questions  (FAQs) document for more information.

If you have any questions, please contact the Network Services Department at 505-837-8800 or toll-free at 1-800-567-8540.

 

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