Claims & Eligibility

Checking eligibility, benefits, and claim status can be accomplished quickly by using electronic options This section provides information and tools to check eligibility, benefits, and claims status.

Claim Status

By checking claim status, providers can verify if claims have been received, pended or finalized. Learn more

Eligibility & Benefits

Check eligibility and benefits to confirm membership, verify coverage and determine other important information such as the patient's copayment, coinsurance and deductible amounts. Learn more

BlueCard® Program Claim Filing

The BlueCard Program links participating health care providers and the independent Blue Cross and Blue Shield (BCBS) Plans across the country and around the world through a single electronic network for claims processing and reimbursement. Learn more about BlueCard.

Electronic Commerce Services

Say goodbye to paper shuffle and say hello to increased operational efficiencies and improved turnaround on payments. BCBSNM is your source for e commerce transactions. Learn more about Electronic Commerce Services.

Interactive Voice Response (IVR) System

Enjoy the Convenience of Self-Service Inquiry Resolution. Our IVR system uses voice recognition technology so that you can obtain automated information on member eligibility, benefits or to adjust a claim. All you need to do is speak your request – the IVR does the rest. Learn more about IVR.

Medicare Advantage Private Fee-for-Service

If you provide care to a Medicare Advantage Private Fee-for-Service (PFFS) member from an out-of-area BCBS Plan, you may use the Web Finder Tool.

Prior Authorization

Information about the prior authorization process at BCBSNM. Learn More

Submitting Claims

At BCBSNM, we are committed to fast and efficient claim processing. In order to prevent delays, billing errors and other potential setbacks, we've put together tips and information to help you manage and submit claims.