News and Updates
• Blue Medical Education Contest • Medical Record Disclosure Request for Hospitals • Concierge Medicine • C PAP and BI PAP rent to purchase change May 1, 2008 • PASS Workshop Schedule • Clear Claim Connection •Zyrtec Now Available OTC •Free Diabetes Glucose Meter
Electronic Commerce
•Electronic Commerce Alerts •Electronic Transactions •EDI Format Specifications •Electronic Funds Transfer (EFT)/Electronic Remittance Advice (ERA) •Clearinghouse Enrollment •EFT/ERA Forms •HealthXNet Online •Availity •HIPAA
Claim Filing
• CMS-1500 (8/05) Claim Form Tutorial • A Guide for Completing the CMS-1500 Form • UB04 User Guide • Timely Claim Filing guidelines • BlueCard Claim Filing instructions • Appeals Process information
Pharmacy
• Drug List - Alphabetic • Drug List - Therapeutic Class • Drug List Limitations, Exclusions, and Prior Authorization Criteria • New Mexico Comparative Formulary • Specialty Pharmacy Program
Provider Network
• Online Provider Finder • Printable Provider Directories • Network Overview
Provider Tools
• Obesity Management Tool Kit Web Site • Hospital Comparison Tool
Provider Library
• Provider Reference Manual •2008 Provider Reference Manual Changes • Medical Policies • Draft Medical Policies • Provider Newsletter • Forms • National Provider Identifier • Interactive Voice Response (IVR) System • Network Services Contacts
UM/QI/Medical Management
• Preventive Health Guidelines: Adult, Children, and Prenatal • Clinical Practice Guidelines: Asthma, Diabetes, Hypertension, Depression • Blue Care Connection Disease Management Programs • Diabetes Guidelines and Reference Materials • Prior Authorization/Approval • Case Management Services
Medicaid Utilization Review
• Review Types • Forms • FAQs • Provider Training • About Medicaid UR • Contact Medicaid UR
Blue Medicare PPO
• Overview • Provider Library • Benefits Summary • Claims • Medical Policy • Pharmacy Services/Drug List • Provider Directory
Contact Us
• BCBSNM Contact Information for Providers
*Note: Some of the information above for BCBSNM providers is available in Adobe Acrobat PDF format. You will need Adobe Acrobat Reader to view the information; this can be downloaded free of charge from Adobe's site.
