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Tools

At Blue Cross and Blue Shield of New Mexico (BCBSNM), we are committed to providing support to physician practices. We’ve designed tools that health care providers find useful. Whether doing research or streamlining billing, these tools can help you evaluate costs, save time, improve service and more.


CareCost EstimatorSM

The Availity® CareCost Estimator tool is an online member liability estimator that can help professional providers estimate a patient's potential out-of-pocket costs in real-time for office and outpatient services provided to BCBSNM members. Learn More


CareProfile®

The CareProfile tool uses claim-based information to provide you with a consolidated view of a patient's health care history at the point of care. Learn More


Claim Inquiry Resolution

The Claim Inquiry Resolution tool allows you to communicate online with our customer advocates in some situations where previously a call or letter was required. Learn More


Claim Research Tool

The Claim Research Tool offers enhanced, real-time claim status functionality to help you manage and resolve your BCBSNM claims. Learn More


Clear Claim Connection

Clear Claim Connection is a web-based code auditing reference tool that mirrors BCBSNM edits (i.e., unbundling, mutually exclusive, and incidental). Learn More


CoverMyMeds®

CoverMyMeds is an online tool for electronic completion and submission of benefit prior authorization (PA) requests for prescription drugs that are part of BCBSNM pharmacy PA program. Learn More


Electronic Refund Management

Electronic Refund Management  is an online tool that can help simplify your overpayment reconciliation and related processes. Learn More


iExchange

iExchange is an automated precertification tool that supports direct submission and provides online approval of benefits for inpatient admissions, as well as select outpatient, pharmacy and behavioral health services 24 hours a day, seven days a week. Learn More


OptiNet® Assessment Tool

OptiNet is an online assessment tool to collect modality-specific data from imaging providers. Learn More


Remittance Viewer

The remittance viewer offers providers and billing services a convenient way to view and help reconcile claim data provided by BCBSNM in the 835 Electronic Remittance Advice (ERA). Learn More

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