February 17, 2020
This is a follow-up to a previous notice regarding delayed implementation of the new Availity Authorizations tool, which was originally scheduled to launch in late January 2020.
We’re pleased to announce that the Availity Authorizations tool (HIPAA-standard 278 transaction) is available as of Feb. 17, 2020, for submission of benefit prior authorization requests handled by Blue Cross and Blue Shield of New Mexico (BCBSNM). This includes benefit prior authorization requests for inpatient admissions and select outpatient services.
For Federal Employee Program® (FEP®) members and behavioral health services, you should continue using your current benefit prior authorization process until this new tool becomes available in the near future.
Important Reminders :
- If you haven’t registered with Availity, you can sign up for free on the Availity website . For help, contact Availity Client Services at 800-282-4548.
- Our current electronic benefit prior authorization submission tool, iExchange®, will be deactivated on April 15, 2020. As of this date, all electronic benefit prior authorization requests handled by BCBSNM should be submitted using the Availity Authorizations tool.
- The process of submitting benefit prior authorization requests through eviCore healthcare (eviCore) or other vendors is not changing.
- Medical and surgical predetermination of benefits requests should be submitted via fax or mail using the Predetermination Request Form, along with the pertinent medical documentation.
Training and Support
We are hosting additional Availity Authorizations training webinars for you to learn how to use this new tool. Select the link below for your preferred date and time to register.
If you have questions or need customized training: Contact our Provider Education Consultants.
iExchange is a trademark of Medecision, Inc., a separate company that provides collaborative health care management solutions for payers and providers.
eviCore is an independent specialty medical benefits management company that provides utilization management services for BCBSNM. eviCore is wholly responsible for its own products and services. Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSNM. BCBSNM makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as eviCore and Availity. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.