Blue Cross and Blue Shield of New Mexico (BCBSNM) has a new catastrophic petition request form 
to be used for catastrophic claim consideration. This form can be found by going to bcbsnm.com, then to the provider section, then to the forms link in the provider library.
The form lists the data elements that are required for BCBSNM to review the claim and determine if it is eligible for catastrophic reimbursement in accordance with the terms of your agreement. Once the data elements are gathered, please place the form on the top of the packet and forward it to BCBSNM at the address on the form. If we need additional information to process the request, a BCBSNM representative will contact you.
If you have any questions, please contact Mike Nelson at (505) 816-2139 or by email.
