Clinical Resources

Behavioral Health Care Management Program

Blue Cross and Blue Shield of New Mexico (BCBSNM) manages behavioral health services for all members who have behavioral health benefits through BCBSNM. Learn More

Blue Care Connection® Condition Management Programs

Blue Care Connection Condition Management Programs are designed to help you enhance the care you provide to BCBSNM members with asthma, diabetes, coronary artery disease, congestive heart failure, COPD; and help reduce morbidity and avoid complications associated with these chronic conditions. Learn More

Care Van Program

The Care Van initiative is a community partnership program. BCBSNM provides the program at no cost to support the outreach efforts of partnering organizations. BCBSNM staffs the program with a full-time coordinator who oversees the schedule, drives the van to service sites, and provides basic logistical support. The New Mexico Department of Health Public Health Division is BCBSNM's primary partner and uses the Care Van to improve outreach to underserved rural communities throughout New Mexico. Learn More

Case Management Services

BCBSNM case managers can offer assistance to members and their families who are facing a serious illness or injury. Our case managers are dedicated professionals with the qualifications and knowledge of member benefits and patient rights essential for navigating members through the sometimes complex maze of medical care. Learn More

Childhood Obesity Provider Toolkit

The percentage of overweight children has more than tripled in the last three decades. The incidence of type 2 diabetes has increased concomitantly. In New Mexico, the prevalence of overweight and obesity is particularly alarming. Learn More

Clinical Practice Guidelines

Clinical practice guidelines distill national recommendations down to clinical guides meant to be more useful for practitioners.

Clinical Practice Guidelines

Clinical Quality Improvement Reference

Clinical quality improvement reference is designed to help providers identify changes in the process for delivery of care and services to better meet the needs of our members.

Clinical Quality Improvement Reference

Diabetes Guidelines and Resources

Resources were developed by New Mexico Health Care Takes On Diabetes, a collaborative of health care plans and providers. Learn More

HEDIS Tip Sheets

We’ve created tip sheets to help you satisfy Healthcare Effectiveness Data and Information Set (HEDIS) measures and code appropriately. These measures from the National Committee for Quality Assurance (NCQA) help ensure our members receive appropriate care. Learn More.

Medical Records Documentation

Medical Records Documentation Standards

Opioid Resources

Blue Cross and Blue Shield of New Mexico (BCBSNM) recognizes the urgent need to address the opioid use, abuse, and addiction epidemic plaguing our communities. BCBSNM has gathered information to help identify patterns of abuse and addiction, guidelines from the CDC, and more. Learn more

Preventive Care Guidelines

View the Preventive Care Guidelines for Clinicians as well as wellness guidelines for adults and children. Learn More

Telemedicine

In response to the COVID-19 pandemic, Blue Cross and Blue Shield of New Mexico (BCBSNM) expanded access to telemedicine services to give our members greater access to care. The experience confirmed the importance of telemedicine in health care delivery. Members can access their medically necessary, covered benefits through providers who deliver services through telemedicine. Many of our members also have access to various telemedicine vendors, such as MDLIVE. Learn More