This form is for Hospitals, Ambulatory Surgery (ASC) and Free-standing Radiology (FSR) Centers that received a letter from BCBSNM requesting updated information for our Care Comparison tool.
You will be using this online form to report the total volume for each procedure and service performed at your facility. The volume should include totals for all payers (i.e., Medicare, commercial, self-pay, etc.) for dates of service in July, 2008, through June 30, 2009.
- Simply click on the appropriate link below to access the online form.
- All fields are required. If you do not perform a particular procedure or service, simply indicate "N/A" for Not Applicable.
- You cannot save or pause once you begin entering data. If you cannot complete the form during one sitting, or if you need to collect information from other sources within your organization, you may want to print the online version, manually compile your data, and then transfer the information to the form online.
- Verify that all information is correct, then click on "Submit."
- Submit your data online no later than February 12, 2010.
All data received will then be incorporated within the Care Comparison tool and made available to members and providers in April 2010.
Please refer to the Frequently Asked Questions 
for more information. If you have additional questions about the Care Comparison tool, please contact Mike Nelson at (505) 816-2139 or by email.
We appreciate your participation!
Note: Your response to this request for information is completely voluntary. If you elect not to respond, a "Not Reported" designation will be displayed on our Web site.
Free-standing Radiology Centers
