iEXCHANGE® Frequently Asked Questions



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If you are a new employee in an office that already uses iEXCHANGE, please contact your office administrator to establish a user name and initial password.


Availity® Single Sign-On (SSO): If you are new to iEXCHANGE, but your office utilizes the Availity Web tool, your organization’s Primary Access Administrator (PAA) can request access to submit BCBSNM preauthorizations from their Availity account (My Account – BCBS Pre Auth Registration) from the left-hand menu. To set up a new iEXCHANGE account, you must be a contracted physician, professional provider or facility within New Mexico. Your PAA will be sent an iEXCHANGE ID, user name and initial password once the registration is complete.


Non-Availity users: If your office is new to iEXCHANGE, you will need to set up an initial administrator account. To set up a new account, you must be a contracted physician, professional provider or facility within New Mexico. If you meet the criteria, complete and submit the online enrollment form. Once registration is complete, your office administrator will be sent an iEXCHANGE ID, user name and initial password.


To register for a scheduled webinar, reference the Training tab under Education and Reference to select a preferred date and time.  If there are no webinars available, please email ProviderOutreachEducation@bcbsnm.com to schedule training. Include your name, office information, billing NPI and telephone number.


iEXCHANGE is available for authorized providers 24 hours a day, 7 days a week – with the exception of the 3rd Sunday of every month when the system will be unavailable from 10:00 a.m. to 2:00 p.m. MT.


Password resets – If you are a new employee in an office that currently uses iEXCHANGE, or you have forgotten your iEXCHANGE password, please contact your office’s iEXCHANGE administrator.


Registration inquiries - For any registration inquiries, your office's iEXCHANGE Administrator should email the Blue Cross and Blue Shield of New Mexico (BCBSNM) iEXCHANGE Help Desk.


For all other system or navigation issues, users should email the BCBSNM iEXCHANGE Help Desk.


The Help Desk assists providers when they are having difficulty utilizing the iEXCHANGE application (i.e., diagnosis codes, reporting issues with iEXCHANGE, resetting Office Administrator passwords, etc.)


No. iEXCHANGE only supports automated preauthorizations for BCBSNM. To learn more about electronic self-service channels for checking eligibility and benefits, please email Provider Outreach Education.


Depending on the service and details of your request, iEXCHANGE may return an auto-approval upon submission. If your case pends, the response time can vary based on the request type submitted. See table below for details:

Request Type Response/Completed
Inpatient
  • Medical/Surgical
Within 2-3 business days
  • Behavioral/Mental Health (NM Medicaid)
Within 5 days
Outpatient
  • Medical/Surgical
Within 2-3 business days
  • Behavioral/Mental Health (IOP)
Within 2-3 business days
  • Pharmacy
    • NM Medicaid
    • NM (Commercial)

 


Within 3 business days
TBD

For additional information, refer to the iEXCHANGE Tip Sheets.


Preauthorization requests can be submitted for the following inpatient services:

  • Surgical
  • Maternity
  • Hospice
  • Neo-natal
  • Rehab
  • Transplant
  • Medical  – applies to anything that does not fall in the other inpatient categories
  • Behavioral health – can only be submitted by New Mexico providers that render services to Blue Cross Medicaid members


Preauthorization requests can be submitted for the following outpatient services:

  • Hospice
  • Skilled nursing visit
  • Home infusion
  • Pharmacy – includes physician-administered medications that are covered under the member’s medical benefits
  • Therapy – includes physical, occupational, and speech therapies
  • Behavioral health – includes services that fall under the Intensive Outpatient Program


Many outpatient services do not require preauthorization; users should verify the member’s eligibility, benefits and confirm preauthorization requirements prior to submitting a request.  To learn more about electronic options for checking eligibility, benefits and preauthorization requirements, please email Provider Outreach Education.


A pended status means your request is being reviewed by the BCBSNM Utilization Management (UM) Department. You can check for a status change through the search function in iEXCHANGE. Generally, you should see an update posted within 48 to 72 business hours.


Users can inquire about an existing request if they are the provider rendering the actual services. This function can be performed by conducting a Treatment search and selecting Member ID or treatment range as the search type.


iEXCHANGE allows providers to perform additional inquiry functions such as: member searches, treatment searches, treatment update searches and provider searches. These inquiries can be requested without initiating an actual preauthorization request. Also, some member search returns do provide additional clinical information, compiled from claims data, available via the Patient Clinical Summary. Also refer to the iEXCHANGE Tip Sheets.


Yes. Regardless of which system the request was originally submitted, requests are also available in iEXCHANGE.


To use iEXCHANGE you must be using a supported web browser. iEXCHANGE currently supports these browsers and versions:

  • Internet Explorer version 6,7,8 and 9
  • Mozilla Firefox all versions


For best results it is recommended that you use a supported web browser version to access iEXCHANGE.