Blue Cross and Blue Shield of New Mexico (BCBSNM) manages behavioral health services for all members who have behavioral health benefits through a variety of group, government and retail products. Similar behavioral health programs are implemented across product lines but may be modified or enhanced dependent upon the product.
Blue Cross Community CentennialSM behavioral health services are managed by BCBSNM for all members who have BCBSNM Community Centennial medical benefits.
Federal Employee Program (FEP) members are managed by BCBSNM. FEP members are not required to request preauthorization for any outpatient behavioral health services, including Partial Hospitalization programs.
Behavioral health care management is integrated with our medical care management program, as part of Blue Care Connection® (BCC), to help members access their behavioral health benefits and to improve coordination of care between medical and behavioral health providers.
This program will help BCBSNM clinical staff identify members who could benefit from co-management earlier, and may result in:
- Improved outcomes
- Enhanced continuity of care
- Greater clinical efficiencies
- Reduced costs over time
Some members* may be referred to other BCC medical care management programs that are designed to help identify and close potential gaps in care through evidence-based and member-focused approaches to health care and benefit decisions.
All behavioral health benefits are subject to the terms and conditions as listed in the member's benefit plan.
* Members experiencing inpatient hospitalization, complex or special health care needs or who are at risk for medical complications may be referred to BCC programs through a variety of mechanisms such as predictive modeling, claim utilization, inbound calls, self-referrals, and physician referrals. If members do not have BCC as part of their group health plans, they will not be referred to other BCC programs.