News and Updates

COVID-19 Preparedness
Blue Review
06/15/2022 Reminder: Initiation of Substance Use Disorder Provider Enhanced Payment Program Blue Cross Community Centennial^SM
06/15/2022 Provider Access and Availability Survey
06/14/2022 Flex and Open Access for Medicare Patients and Providers
06/14/2022 CT Contrast Shortage
06/10/2022 Member Rights and Responsibilities
06/10/2022 Provider Rights and Responsibilities
06/10/2022 Catch Up on Routine Vaccines and Well-Child Visits
06/06/2022 In-home Test Kits for Colorectal Cancer Screening
06/03/2022 Provider Satisfaction Survey 2022
06/03/2022 Pricing Information to Display Starting in July
05/09/2022 CPT Codes Updated for PA, Eff July 1
05/09/2022 CPT Codes Updated for PA for MA Programs, Eff July 1
05/09/2022 2022 NM Annual NDC Drug Fee Schedule Impact and Timeline
05/09/2022 Managing Diabetes
05/06/2022 Earn Continuing Education Credit at Webinar on Avoiding Inappropriate Antibiotic Use
05/05/2022 ClaimsXten™ Quarterly Update Reminder
05/05/2022 Availity® Essentials Claim Status Tool Update
05/05/2022 Submit Multiple Clinical Claim Appeal Requests Online
05/05/2022 Education information Requirement for Directory
05/05/2022 Behavioral Health Collaboration Requests
05/05/2022 Reminder: Closing Gaps in Care for Group Medicare Advantage Members
05/05/2022 Pharmacy Program Updates: Quarterly Pharmacy Changes Effective July 1, 2022 – Part 1
05/05/2022 Preferred Drug Program
04/28/2022 Avalon Program Postponement
04/08/2022 New 'Message This Payer' Option Coming Soon via Availity® Essentials
04/08/2022 NM Provider Pharmacy Changes Effective April 2022- Part 2
04/08/2022 Follow-Up Care for Substance Abuse Disorders
04/08/2022 Credentialing Requirements for Facility-Based Providers
04/08/2022 Gender Code Reminder- Coding for Breast Augmentation and Removal for Gender Affirming Surgery
04/08/2022 Current Procedural Terminology^® (CPT) Codes Updated for Prior Authorization for Medicare programs, Effective July 1
04/08/2022 BCBSNM Supporting Care During and After Pregnancy
04/08/2022 BCBSNM Avalon Second Launch Training Reminder
03/28/2022 Advisory on Telemedicine Services – Place of Service (POS) Codes
03/28/2022 Third-Party Liability Claims Processing for Blue Cross Community Centennial^(SM)
03/28/2022 Training, Access the New Lab Management Program Trial Tool April 1, 2022
03/18/2022 Changes Coming to FEP Out-of-State Claims Processing
03/18/2022 Surprise Billing Provisions of No Surprises Act - Updated
03/11/2022 Closing Gaps in Colon Care
03/11/2022 Supporting Mental Health
03/11/2022 Free Behavioral Health Webinars and Continuing Education Credit
03/07/2022 ClaimsXten^TM Quarterly Update Reminder
03/07/2022 Current Procedural Technology^® (CPT) Codes Updated for Prior Authorization
03/04/2022 CMS Payment Adjustments for Medicare Providers Extended Through March 31, 2022
03/03/2022 Verify and Update your Information Online with Availity^® Provider Data Management
03/03/2022 All Contracted Providers Will Now Display in Provider Finder^®
02/17/2022 Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Apr. 1, 2022 - Part 1
02/07/2022 Differential Diagnoses of Depression
02/07/2022 Closing Gaps in Care for Group Medicare Advantage Members
02/03/2022 New Laboratory Management Program to Begin On May 1, 2022
01/26/2022 It’s Time - Verify Your Directory Details
01/26/2022 Supporting Healthy Hearts
01/20/2022 Behavioral Health Cost Share Waiver for Some BCBSNM Members Begins Jan. 1, 2022
01/18/2022 Update - New Lab Policies and Laboratory Management Program Delayed
01/13/2022 2022 Annual HEDIS^® Medical Record Review Begins February 2022
01/13/2022 Delivering Quality Care: Cervical and Breast Cancer Screenings
01/13/2022 Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Jan. 1, 2022 – Part 2
01/13/2022 EXL Health Is Reviewing Complex Claims
01/10/2022 Blue Cross Community Centennial^SM Prior Authorization Update for MSK Therapies (Rehab) effective March 13, 2022, and Training Webinars
01/05/2022 Reminder: Claim Editing Enhancements Coming in 2022, Register for a Training Webinar
12/30/2021 Current Procedural Terminology^® (CPT) Codes Updated for Prior Authorization
12/30/2021 Current Procedural Terminology^® (CPT) Codes Updated for Prior Authorization for Medicare programs
12/30/2021 Availity^® Tools to Support Providers in 2022
12/27/2021 New Lab Policies and Laboratory Management Program Delayed
12/23/2021 OSI Emergency Order for LTC Transfer PA
12/21/2021 Behavioral Health Cost Share Waiver for Some BCBSNM Members Begins Jan. 1, 2022
12/17/2021 Chiropractic & Mixed Therapy Benefits Contained in IVR Phone System as of Jan. 3, 2022
12/09/2021 Claim Editing Enhancements Coming April 1, 2022
12/07/2021 Patients in the Qualified Medicare Beneficiary Program Should Not Be Billed
12/07/2021 Hospitals Must Provide Medicare Outpatient Observation Notice
12/07/2021 Rural Health Clinics and Federally Qualified Health Centers May Meet Quality Measure
12/07/2021 Webinar on Avoiding Antibiotics Overuse
12/07/2021 COVID-19 Vaccine Billing for Medicare Advantage Members
12/07/2021 Current Procedural Terminology (CPT^®) Codes Updated for Prior Authorization, Jan. 1, 2022
12/06/2021 Behavioral Health Cost Share Waiver for Some BCBSNM Members Begins Jan. 1, 2022
12/06/2021 New Flexible Medicare Advantage PPO Plan
11/26/2021 Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Jan. 1, 2022 – Part 1
11/24/2021 COVID-19 Vaccine Billing for Medicare Advantage Members
11/24/2021 Current Procedural Terminology (CPT^®) Codes Updated for Prior Authorization
11/24/2021 Current Procedural Terminology (CPT^®) Codes Updated for Prior Authorization for Medicare programs
11/24/2021 Single Sign-On Access to AIM Specialty Health^® via Availity^®
11/24/2021 View Withdrawn Claim Descriptions via the Availity^® Claim Status Tool
11/24/2021 Watch for a Letter on Fighting Fraud, Waste and Abuse
11/19/2021 New Provider Designations and Services Forms for Provider Onboarding Applications
10/25/2021 Claim Editing Enhancements Coming Jan. 10, 2022
10/22/2021 Catch Up on Vaccines for All Ages
10/20/2021 Continuity of Care Changes
10/20/2021 Machine-Readable Files
10/20/2021 New Information on Member ID Cards
10/20/2021 Provider Directory Information Verification
10/20/2021 Surprise Billing Provisions of No Surprises Act
10/20/2021 Initiation of Substance Use Disorder Provider Enhanced Payment Program Blue Cross Community Centennial^SM
10/20/2021 Provider Incentive Program for Weight Assessment and Counseling for Children and Adolescents - Blue Cross Community Centennial^SM
10/20/2021 2022 Telemedicine Services
10/20/2021 New Laboratory Policies Coming Jan. 1, 2022
10/20/2021 Avoiding Antibiotics for Acute Bronchitis
10/20/2021 Managing Diabetes
10/20/2021 Introducing Electronic Clinical Claim Appeal Requests via Availity^® Provider Portal for Federal Employee Program^® (FEP^®) and Blue Cross Community Centennial^SM claims
10/18/2021 Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Oct. 1, 2021 – Part 2
09/15/2021 In-Home Diabetes Monitoring Tests Coming to Select Blue Cross Community Centennial^SM Members
09/08/2021 Coding Cancer and Cancer-Related Treatments
09/08/2021 Obesity and Morbid Obesity
09/08/2021 Change to Some Primary and Secondary Claims Coordination
09/08/2021 Are you using these shared decision-making aids?
09/08/2021 Coverage Replacement for Smoking Cessation Product CHANTIX^® Due to Voluntary Recall
09/08/2021 Managing Diabetes
09/03/2021 Reminder: Use AIM for Prior Authorization - Coming for Pharmacy Medical Oncology
08/17/2021 Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Oct. 1, 2021 – Part 1
08/17/2021 Availity^® Claim Status Response Enhancement for Medicare Advantage Claims
08/05/2021 NM DOH Announces Second Round of Incentives for COVID-19 Vaccines
07/12/2021 Prior Authorization Update - Pharmacy Medical Oncology
07/12/2021 View Professional Provider Fee Schedule via Availity^® – Coming Soon
07/11/2021 National Drug Code (NDC) Fee Schedule Changes Effective Sept. 1, 2021
07/11/2021 Colorectal Cancer Screening for Members Age 45 to 75
06/24/2021 Pharmacy Program Updates: Quarterly Pharmacy Changes Effective July.1, 2021 – Part 2
06/08/2021 Prepayment Reviews on Inpatient DRG Claims for BlueCard members
05/28/2021 In-Home Test Kits for Colorectal Cancer Screening
05/28/2021 Free Webinar and CME on Depression
05/28/2021 Catch Up Now on Child and Adolescent Vaccinations
05/27/2021 BCBSNM Members Have New Mail Order and Specialty Pharmacies as of May 1, 2021
05/13/2021 EXL Health to Review Complex Claims July 1, 2021
05/13/2021 National Drug Code (NDC) Fee Schedule Change for Octagam (J1568)
05/13/2021 Reminder: Single Access Point for EFT and ERA Enrollments
05/12/2021 Delivering Quality Care: Treating Substance Abuse
05/10/2021 COVID-19 Vaccine Administration Reimbursement – HSD Supplement 16
05/10/2021 Pharmacy Program Updates: Quarterly Pharmacy Changes Effective July 1, 2021 – Part 1
05/06/2021 Cervical Cancer Screening May Save a Life
05/06/2021 Caring for the Colon
05/05/2021 New Applied Behavior Analysis (ABA) Service Request Forms
04/15/2021 Select Medication List to be Updated June 1, 2021
04/09/2021 Pharmacy Program Updates: Quarterly Pharmacy Changes Effective April.1, 2021 – Part 2
04/09/2021 Reminder: eviCore to Manage Prior Authorization Appeals Process through April 2021 for 2020 Adverse Determinations
04/08/2021 Some Codes Removed from AIM^® Prior Authorization
03/19/2021 Updates Made to the Provider Reference Manual
03/12/2021 Single Access Point for 835 EFT and ERA Enrollments
03/01/2021 Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Apr. 1, 2021, Part 1
02/16/2021 Atrial Fibrillation
02/16/2021 Diabetes Mellitus
01/05/2021 Healthcare and Related Personnel Eligible for Phase 1a Vaccinations
12/29/2020 Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Jan.1, 2021 – Part 2
12/23/2020 Comprehensive Care Plans to be Emailed or Faxed
12/23/2020 Quality Health Standards –Prenatal and Postpartum Visits
12/22/2020 COVID-19 Vaccines and Coverage
12/17/2020 Billing Reminders for Psychological and Neuropsychological Testing
12/17/2020 Revision to Specialty Medication Administration Site of Care Policy, Effective Jan. 1, 2021
12/17/2020 Outpatient Provider Incentive Program for Behavioral Health Follow-up Visit
12/15/2020 Obtain BCBSNM Patient ID Numbers Online via Availity^® – Now Available for Government Programs
12/15/2020 View, Download and Print the BCBSNM Member's ID Card Online via the Availity^® Provider Portal
12/15/2020 Verify Multiple Patient's Eligibility and Benefits Coverage via Availity^®
12/15/2020 New Electronic Duplicate Claim Rejections for Commercial Claims Effective Nov. 14, 2020
12/15/2020 Submit Electronic Professional and Facility Claims via the Availity^® Provider Portal
12/15/2020 Patients in the Qualified Medicare Beneficiary (QMB) Program Should Not Be Billed
12/15/2020 Hospitals Must Provide Medicare Outpatient Observation Notice (MOON)
12/14/2020 Coverage for Coronary Artery Calcium Scan for Cardiovascular Disease Risk Assessment
12/11/2020 Transition of Care: Prior Authorization Changes from eviCore to AIM for Some Members effective Jan. 1, 2021
12/11/2020 Providers receiving bamlanivimab for free should not bill for the product
12/10/2020 BCBSNM will update CPT^® codes for some prior authorization services effective Jan. 1, 2021
11/17/2020 New HEDIS^® Tip Sheets for Behavioral Health HEDIS Measures: APM and UOP
11/16/2020 Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Jan. 1, 2021, Part 1
11/05/2020 Availity^® Provider Portal Offerings
10/29/2020 BCBSNM Moving Prior Authorization Duties from eviCore to AIM Effective Jan. 1, 2021, for Some Members
10/22/2020 Continuity and Coordination of Care - Free Webinar and Continuing Education Credit for Providers
10/12/2020 Provider Finder^® Gets an Upgrade
10/12/2020 Telemedicine – Future State
10/08/2020 Updates and Reminders: Submit Predetermination of Benefits Submission via Availity^®
10/08/2020 Availity Claim Status Tool Now Available for All BCBSNM Members
09/29/2020 New national high-performance network to launch in January
09/29/2020 New HEDIS^® Tip Sheets* Behavioral Health HEDIS Measures: FUA and FUM
09/28/2020 Itemized Bills Required for BlueCard^® Facility Claims Over $100k
09/28/2020 Clinical Practice and Preventive Care Guidelines Updated for 2020-2021
09/28/2020 Childhood Immunization Rates Fall Amidst Pandemic Fears
09/18/2020 Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Oct.1, 2020 – Part 2
09/17/2020 What You Need to Know About Substance Abuse - Free Webinar and Continuing Education Credit for Providers
09/14/2020 In-Home Diabetes Monitoring Tests Coming to Select Blue Cross Community Centennial^SM Members
09/11/2020 Verify Procedure Code Preauthorization Requirements and Submit the Request via Availity^®
09/04/2020 Census 2020
09/02/2020 Updated Behavioral Health Measures from HEDIS^® 2020-21*
08/31/2020 Telehealth Visits – Medicare Advantage
08/31/2020 Obtain BCBSNM Patient ID Number Numbers Online via Availity^®
08/27/2020 Blue Distinction^® Message via the Availity^® Eligibility and Benefits Results
08/19/2020 Physical Therapy Benefits to be Contained Within the IVR Phone System as of Sept. 8, 2020
07/31/2020 iExchange^® Will Be Deactivated on Aug. 17, 2020
07/31/2020 Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Oct. 1, 2020, Part 1
07/31/2020 Depression? How Do You Know? Free Webinar and Continuing Education Credit for Providers
07/30/2020 Blue Cross Medicare Advantage Prior Authorization Updates effective Sept. 1, 2020
07/30/2020 Addition of New Prior Authorization Requirements for Blue Cross Community Centennial^SM Members
07/28/2020 Threshold Amount for Claims Review for Blue Cross Community Centennial^SM Members
07/27/2020 Submit Predetermination of Benefit Requests via the Availity^®
07/24/2020 Overpayment Recovery Process for Contracted Providers
07/24/2020 Colorectal Cancer Screening at Home
07/24/2020 Imaging Studies for Low Back Pain for FEP Members
07/24/2020 Two New Behavioral Health Measures Tip Sheets
07/22/2020 Retainer Payments for Personal Care Services Providers - Special COVID LOD #12; Community Benefit, Appendix K
07/02/2020 CMS Payment Adjustments for Medicare Providers
07/01/2020 Federal Agencies Extend Timely Filing and Appeals Deadlines
06/17/2020 New Email Address for Prior Authorization Appeals Changing Effective July 1, 2020
06/15/2020 Pharmacy Program Updates: Quarterly Pharmacy Changes Effective July 1, 2020 – Part 2
06/10/2020 BCBSNM will update CPT^® codes for some preauthorization services
06/08/2020 COVID-19 Coverage Updates for Medicare Providers
05/26/2020 Calls to Electronic Commerce Services will be Redirect to Email as of June 15, 2020
05/19/2020 COVID-19 Initiatives Extended into June
05/14/2020 Extending Prior Authorization on Previously-Approved Elective Surgeries, Procedures and Therapies (Updated)
05/13/2020 Pharmacy Program Updates: Quarterly Pharmacy Changes Effective July 1, 2020, Part 1
04/29/2020 Making It Easier to Access Chest CT Scans
04/29/2020 BCBSNM Making It Easier to Transfer Members to Post-Acute Care
04/24/2020 Blue Cross and Blue Shield of New Mexico Further Expands Telemedicine to All In-Network Providers
04/20/2020 CARES Act Provider Relief Summary
04/15/2020 Extending Prior Authorization on Previously-Approved Elective Surgeries, Procedures, and Therapies
04/14/2020 Alert: iExchange^® Deactivation Extended Due to COVID-19
04/10/2020 New Guidance and Recommendations for Personal Care Services Providers
04/10/2020 BCBSNM Waives Customer Cost-Sharing for COVID-19 Treatment
04/08/2020 New Mexico Human Services Department Issues Special COVID-19 Supplement #3 “Guidance for New Mexico Medicaid Providers” to MAD NMAC Program Rules
04/07/2020 New Mexico Human Services Department Issues Letter of Direction #31 – COVID-19 Guidance for Centennial Care 2.0 Managed Care Organizations Repeal & Replace LOD #30
04/02/2020 A letter to Behavioral Health Providers from HSD Director of Behavioral Health Services Division Neal Bowen
03/31/2020 Reminder: iExchange^® Deactivating on April 15, 2020 – Use the Availity^® Authorizations Tool
03/30/2020 Using Telemedicine and Telehealth in Response to COVID-19
03/27/2020 Medicare Advantage Provider Call Center Lines Experiencing Longer Hold Times
03/27/2020 Temporary Changes for In-Home Services, Community Benefits, and Nursing Facility Level of Care Determinations
03/27/2020 New Mexico Human Services Department Issues Letter of Direction #30 – COVID-19 Guidance for Centennial Care 2.0 Managed Care Organizations
03/19/2020 New Mexico Centennial Care 2.0 Letter of Direction #30 - COVID-19 Guidance for CC 2.0 MCOs
03/19/2020 Pharmacy Program Updates: Quarterly Pharmacy Changes Effective April 1, 2020 – Part 2
03/17/2020 Clarification: New BCBSNM 837 Commercial Claim Validation Edits Effective April 1, 2020
03/11/2020 COVID-19 Preparedness in New Mexico
03/03/2020 New BCBSNM 837 Commercial Claim Validation Edits
03/02/2020 Three New ClaimsXten^TM Rules to be Implemented June 2020
02/27/2020 CMS Star Ratings Matter: Survey to Assess Medicare Advantage Members’ Experiences
02/26/2020 Obtain Your Provider Claim Summary (PCS) Online – PCS Mailing Discontinuation as of May 4, 2020
02/19/2020 Pharmacy Program Updates: Quarterly Pharmacy Changes Effective April 1, 2020, Part 1
02/18/2020 Resolved: Electronic Payment and Remittance Delivery Delay
02/17/2020 New Authorizations Tool via Availity Provider Portal^®: Revised Launch Date of Feb. 17, 2020
02/14/2020 Electronic Payment and Remittance Delivery Delay
02/06/2020 Prior Authorization Changes for ID Prefixes BBE, BHP, BNK, BRG and BYR
01/30/2020 Implementation Delay: Authorizations via Availity^® Provider Portal
01/22/2020 Eight Steps Toward Health Equity in Hypertension
01/22/2020 Eight Steps Toward Health Equity in Diabetes
01/17/2020 Updates Made to the Medicare Advantage Section of the Blues Provider Reference Manual
01/13/2020 Survey Shows Medicaid Members Give Their Providers High Ratings
01/13/2020 Our Medicaid Quality Improvement Program
01/06/2020 Reminder: New Online Enrollment Process for 835 EFT and ERA through the Availity^® Provider Portal

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Medicare Part D Updates