Medicaid Providers: Learn what's new on iEXCHANGE® for 2014
Effective Jan. 1, 2014, Blue Cross and Blue Shield of New Mexico is enhancing iEXCHANGE®, its web-based preauthorization tool, to support requests for additional Behavioral Health and Pharmacy services.
With the iEXCHANGE portal you can submit initial and extension requests for approval prior to services being rendered, once eligibility, benefits and preauthorization requirements have been confirmed through your current process. This flexible tool provides you with real-time response for direct submission of inpatient admissions and select outpatient medical services and enables you to send preauthorization submissions after hours and on weekends.
This enhancement will serve a dual purpose of offering an electronic option to the current manual process of faxing the handwritten form that is required for pharmacy requests as well as a comparable online solution for behavioral health requests submitted for Blue Cross Community CentennialSM members. Now with iEXCHANGE, providers will have the ability to submit online requests for inpatient behavioral health admissions and physician-administered medications.
Webinars are scheduled throughout the month to update providers on how to initiate preauthorizations as well how to search for any previously submitted requests. January sessions are listed below. To register, select your preferred day.
For more information about iEXCHANGE, including how to register if you are not a current user, visit the Provider Tools page.
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Please note that the fact that a service has been preauthorized/pre-certified is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member's eligibility and the terms of the member's certificate of coverage applicable on the date services were rendered.
Services are funded in part under a contract with the State of New Mexico.
Blue Cross and Blue Shield of New Mexico refers to the HCSC Insurance Services Company (HISC), which is a wholly owned subsidiary of Health Care Services Corporation (HCSC), a Mutual Legal Reserve Company. Both HISC and HCSC are Independent Licensees of the Blue Cross and Blue Shield Association.