Learn About Enhancements to Medicaid Utilization Management Process, Effective Sept. 18, 2026

Aug. 14, 2026

Effective Sept. 18, 2026, we’re launching Medicaid Authorizations, a new application in Availity® Essentials that will help streamline the process for submitting and managing utilization management requests for New Mexico Medicaid members. A preview is below. We encourage you to attend a September webinar to learn more.

What’s new: Through Medicaid Authorizations, you’ll be able to check in real time if prior authorization or notification is required for Medicaid members. For requests handled by Blue Cross and Blue Shield of New Mexico if prior authorization is required, you'll move directly into the request submission process. You’ll be able to submit concurrent reviews, attach medical documentation and view letters online. 

How to access: You’ll initiate a request through Availity Authorizations & Referrals the same way you do today, in the same workflow. To access Medicaid Authorizations, select Turquoise Care as the payer. You’ll also have the option to access Medicaid Authorizations through Availity Payer Spaces. 

Sign up for a webinar: We’re offering training sessions on how to navigate Medicaid Authorizations. Refer to Availity Essentials Training to register for your preferred date and time. You must be a current Availity user to register for and attend these training sessions. 

  • Sept. 14, 2026 – 1 to 2 p.m. MT
  • Sept. 15, 2026 – 9 to 10 a.m. MT
  • Sept. 16, 2026 – 2 to 3 p.m. MT
  • Sept. 17, 2026 – 10 to 11 a.m. MT

The webinars will include a demo and quick tips, such as how to:

  • Select the correct payer
  • Use the member search result and active eligibility to build your request
  • Conduct a quick search when entering provider information
  • Search and select diagnosis and procedure codes to automatically populate descriptions
  • Save draft requests to complete later that day

Why it matters: Medicaid Authorizations will help you continue to get the information you need quickly and efficiently by allowing you to:

  • Submit authorization requests 24x7
  • Include minimum necessary supporting data to confirm if authorization is required
  • Receive authorization determinations and track request status in real time
  • Easily upload supporting documentation for our clinical team
  • Reduce unnecessary calls, faxes and paperwork

More information: We’ll review detailed instructions in our upcoming webinars. Also watch our Availity Authorizations & Referrals page for a new Medicaid Authorization Portal user guide. 

Checking eligibility and/or benefit information and/or obtaining prior authorization is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage, including, but not limited to, exclusions and limitations applicable on the date services were rendered. Regardless of any prior authorization or benefit determination, the final decision regarding any treatment or service is between the patient and the health care provider.

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 third party vendors and the products and services they offer.