Provider Training and Continuing Education

In these one-hour webinar sessions, providers will learn how electronically submit prior authorization requests handled by BCBSNM using the Availity Essentials Authorizations tool. You will also learn how to access and use BlueApprovR via Availity Essentials to submit specialty pharmacy drug, Behavioral health clinical evaluation and medical surgical prior authorization requests.

New and existing Availity Essentials users are highly encouraged to attend. To register for a complimentary webinar, select a session date & time below.

• March 8, 2023 – 10 a.m. to 11 a.m.
• March 15, 2023 – 10 a.m. to 11 a.m.
• March 22, 2023 – 10 a.m. to 11 a.m.
• March 29, 2023 – 10 a.m. to 11 a.m.
• April 5, 2023 – 10 a.m. to 11 a.m.
• April 12, 2023 – 10 a.m. to 11 a.m.
• April 19, 2023 – 10 a.m. to 11 a.m.
• April 26, 2023 – 10 a.m. to 11 a.m.
• May 3, 2023 – 10 a.m. to 11 a.m.
• May 10, 2023 – 10 a.m. to 11 a.m.
• May 17, 2023 – 10 a.m. to 11 a.m.
• May 24, 2023 – 10 a.m. to 11 a.m.
• May 31, 2023 – 10 a.m. to 11 a.m.
• June 7, 2023 – 10 a.m. to 11 a.m.
• June 14, 2023 – 10 a.m. to 11 a.m.
• June 21, 2023 – 10 a.m. to 11 a.m.
• June 28, 2023 – 10 a.m. to 11 a.m.

BCBSNM is hosting complimentary webinars for providers to learn how to efficiently verify detailed claim status, submit clinical claim appeals and send secure claim management questions online using the Availity Essentials Claim Status tool. Select your preferred date and time below to register for an upcoming session.

• March 9, 2023 – 10 a.m. to 11 a.m.
• March 16, 2023 – 10 a.m. to 11 a.m.
• March 23, 2023 – 10 a.m. to 11 a.m.
• March 30, 2023 – 10 a.m. to 11 a.m.
• April 6, 2023 – 10 a.m. to 11 a.m.
• April 13, 2023 – 10 a.m. to 11 a.m.
• April 20, 2023 – 10 a.m. to 11 a.m.
• April 27, 2023 – 10 a.m. to 11 a.m.
• May 4, 2023 – 10 a.m. to 11 a.m.
• May 11, 2023 – 10 a.m. to 11 a.m.
• May 18, 2023 – 10 a.m. to 11 a.m.
• May 25, 2023 – 10 a.m. to 11 a.m.
• June 1, 2023 – 10 a.m. to 11 a.m.
• June 8, 2023 – 10 a.m. to 11 a.m.
• June 15, 2023 – 10 a.m. to 11 a.m.
• June 22, 2023 – 10 a.m. to 11 a.m.
• June 29, 2023 – 10 a.m. to 11 a.m.

Join us for a review of electronic transaction, provider tools and helpful online resources.

• March 7, 2023 – 10 a.m. to 11 a.m.
• March 14, 2023 – 10 a.m. to 11 a.m.
• March 21, 2023 – 10 a.m. to 11 a.m.
• March 28, 2023 – 10 a.m. to 11 a.m.
• April 4, 2023 – 10 a.m. to 11 a.m.
• April 11, 2023 – 10 a.m. to 11 a.m.
• April 18, 2023 – 10 a.m. to 11 a.m.
• April 25, 2023 – 10 a.m. to 11 a.m.
• May 2, 2023 – 10 a.m. to 11 a.m.
• May 9, 2023 – 10 a.m. to 11 a.m.
• May 16, 2023 – 10 a.m. to 11 a.m.
• May 23, 2023 – 10 a.m. to 11 a.m.
• May 30, 2023 – 10 a.m. to 11 a.m.
• June 6, 2023 – 10 a.m. to 11 a.m.
• June 13, 2023 – 10 a.m. to 11 a.m.
• June 20, 2023 – 10 a.m. to 11 a.m.
• June 27, 2023 – 10 a.m. to 11 a.m.

We offer the following free behavioral health webinars. Doctors (MDs and DOs), nurses, physician assistants, physical and occupational therapists, and psychologists earn one continuing medical education (CME) credit for each course attended, unless otherwise noted. Social workers and mental health counselors (LPC, LCPC, LPCC) earn one continuing education unit (CEU) per course. 

Maternal Mental Health: Pregnancy and Postpartum

Earn one CME or CEU for attending this introductory training. We’ll offer this webinar twice:

• April 3, 2023, from 7 to 8 a.m. Mountain time. Register here to attend.
• April 5, 2023, from 8 to 9 a.m. Mountain time. Register here to attend.

Synthetic Opioids and the Opioid Crisis

Earn one CME or CEU for attending this introductory training. We’ll offer this webinar twice:

• April 24, 2023, from 7 to 8 a.m. Mountain time. Register here to attend.
• April 26, 2023, from 8 to 9 a.m. Mountain time. Register here to attend.

Other Continuing Education Credits: Recorded Webinars

Sign in (registration required) to view recordings of our previous webinars and earn CME/CEU credit: 

These courses are available:

• Bipolar Disorder: Diagnosis and Treatment, recorded February 2023 (1.5 CME/CEU)
• Comorbid Behavioral Health and Physical Health Conditions, recorded October 2021
• Depression in a Primary Care Setting, recorded June 2021
• Diabetes and Behavioral Health, recorded April 2022
• Differential Diagnoses of Depression: Assessment and Treatment, recorded March 2022
• Opioid Use Disorder, recorded August 2021
• Substance Abuse: Coordinating Care and Improving Follow-Up, recorded May 2022
• Suicide Prevention with the Military Community, recorded November 2022 (1.5 CME/CEU)

The webinars offer introductory training and a high-level overview.

_{The New Mexico Osteopathic Medical Association (NMOMA) is accredited by the American Osteopathic Association to provide osteopathic continuing medical education for physicians. NMOMA designates this program for a maximum of 1 AOA Category 1-A credits (or 1.5 if noted) and will report CME and specialty credits commensurate with the extent of the physician's participation.}

_{Social Work CEUs Approved by NASW-NM. The Licensee must maintain proof of continuing education courses taken for the past four (4) years. The New Mexico Regulations and Licensing Department, Boards and Commissions, Social Work Licensing Board reserves the right to audit a licensee’s continuing education records as it deems necessary. This event has been approved for a total of 1 CEU (or 1.5 if noted).}

_{Physicians, nurses, physician assistants, nurse practitioners and psychologists can use AOA Cat 1-4 credit toward licensure. Social workers and mental health counselors (LPC, LCPC, LPCC) can use the Social Work CEU credit toward licensure.}

_{The above material is for informational purposes only and is not intended to be a substitute for the independent medical judgment of a physician. Physicians and other health care providers are encouraged to use their own best medical judgment based upon all available information and the condition of the patient in determining the best course of treatment.}

Learn how to access and use BlueApprovR via Availity Essentials to submit and secure real-time approvals for specialty pharmacy drug, behavioral health clinical evaluation and medical surgical prior authorization requests for many BCBSNM commercial members.

Register for an instructor-led webinar session by selecting your preferred date and time below: 

• March 9, 2023 – 9 a.m. to 10 a.m.
• March 16, 2023 – 9 a.m. to 10 a.m.
• March 23, 2023 – 9 a.m. to 10 a.m.
• March 30, 2023 – 9 a.m. to 10 a.m.
• April 6, 2023 – 9 a.m. to 10 a.m.
• April 13, 2023 – 9 a.m. to 10 a.m.
• April 20, 2023 – 9 a.m.to 10 a.m.
• April 27, 2023 – 9 a.m. to 10 a.m.
• May 4, 2023 – 9 a.m. to 10 a.m.
• May 11, 2023 – 9 a.m. to 10 a.m.
• May 18, 2023 – 9 a.m. to 10 a.m.
• May 25, 2023 – 9 a.m. to 10 a.m.
• June 1, 2023 – 9 a.m. to 10 a.m.
• June 8, 2023 – 9 a.m. to 10 a.m.
• June 15, 2023 – 9 a.m. to 10 a.m.
• June 22, 2023 – 9 a.m. to 10 a.m.
• June 29, 2023 – 9 a.m. to 10 a.m.

BCBSNM is offering the courses listed below to earn continuing education credit. These webinars are offered at no cost through Quality Interactions, a separate company that provides cultural awareness training to health care professionals.  

Course Offerings

Select the link for accreditation information and course overviews:

• Recognizing and Responding to Implicit Bias (CME/CEU/CCM/CDE)
• Cross-Cultural Care in Mental Health and Depression (CME/CEU/CCM/LSW)
• Culturally Competent Care for the Medicare Population (CME/CEU/CCM)
• Improving Adherence in Diverse Populations (CME/CEU/CCM/LSW/ACPE)
• Test Your Skills for Clinicians (option A) (CME/CEU/CCM)
• Test Your Skills for Clinicians (option B) (CME/CEU)

How to Attend

• Enter your email address and create a password on the Quality Interactions website.
• Watch your email for a link to your new account profile. Complete your profile and enter Learn2022 as your Org ID.

The courses are self-paced. Find instructions and get help online.

_{Quality Interactions is a separate company that provides cultural competency training to health care professionals. BCBSNM makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.}

• Electronic Funds Transfer (EFT) — a secure method of claims payment
• Electronic Remittance Advice (ERA) — an electronic file that explains claim payment and remittance information
• Electronic Payment Summary (EPS) — an electronic print image of the Provider Claim Summary

Learn more about these electronic solutions

eRM is an online tool that can help simplify your overpayment reconciliation and related processes. Learn More

The primary mission of BCBSNM Special Investigations Department (SID) is to identify, prevent, investigate, and stop potential fraudulent activities. The SID is committed to fighting fraud, reducing health care costs, and protecting the integrity of the BCBSNM provider network.

Each year billions of dollars are inappropriately spent due to health care fraud, waste, and abuse which contributes to the rising cost of health care for all Americans. In response to this problem, BCBSNM has an established SID – one of the most aggressive and effective health care fraud investigation programs in the industry.

To help you understand what health care fraud is, how it affects your practice, and how you can report health care fraud to the SID, BCBSNM offers a free online Fraud Awareness Training Tutorial .

BCBSNM considers fraudulent billing to include, but not be limited to:

• Deliberate misrepresentation of the services provided to receive payment for a non-covered service.
• Deliberately billing in a manner which results in a reimbursement greater than what would have been received if the claim was properly filed.
• Billing for services that were not rendered.

Additionally, the SID maintains a 24-hour fraud hotline, through which you can report any suspicions of fraud. All calls are confidential, and you may report your information anonymously. To file a report, call the hotline at 1-800-543-0867 (24/7) or go to bcbsnm.com/sid/reporting.

Our IVR system uses voice recognition technology so that you can obtain automated information on member eligibility, benefits or to adjust a claim. All you need to do is speak your request — the IVR does the rest. Learn More

2019 Commercial and Medicare Plans Provider Training

2020 Medicare Provider Training 

The Centers for Medicare & Medicaid Services (CMS) requires all Special Needs Plans (SNPs) to provide an annual training on the Model of Care (MOC) for all providers who provide services to SNP members. To ensure that you receive credit for completing the training, please reach out to your location Provider Network Representative at 1-800-567-8540.

Dual Special Needs Population (DSNP) Model of Care Provider Interactive Training 

Dual Special Needs Population (DSNP) Model of Care Provider Training

Annual Cultural Competency Training is required by the New Mexico Human Services Department for all providers contracted within a New Mexico Medicaid network, like Blue Cross Community Centennial. Please have your 10-digit NPI number ready when starting the training or attestation below. Do not use any dashes or spaces when entering your NPI, and make sure your NPI is entered correctly before proceeding with the rest of the training or attestation.

• Cultural Competency Training 
• Cultural Competency Training Attestation 

These online tools offer providers and billing services a convenient way to view claim detail information from the 835 Electronic Remittance Advice (835 ERA) and the Provider Claim Summary (PCS). Attend a webinar to learn how to gain or grant access, conduct a search, view general and payer specific information, and save or print results.

To register, select a webinar date and time from the list below:

• March 16, 2023 – 12 p.m. to 1 p.m.
• April 20, 2023 – 12 p.m. to 1 p.m.
• May 18, 2023 – 12 p.m. to 1 p.m.
• June 15, 2023 – 12 p.m. to 1 p.m.