Automated Phone System Change for Behavioral Health Services
Checking eligibility and benefits electronically through the Availity® Provider Portal or your preferred Web vendor is the quickest way to access behavioral health coverage information for Blue Cross and Blue Shield of New Mexico (BCBSNM) members. Online eligibility and benefit quotes include the patients’ coverage status and benefit details, such as applicable copayment, coinsurance, deductible amounts and preauthorization requirements.
As of December 16, 2018, in the event a call to BCBSNM is needed to verify patient coverage for behavioral health services, providers must first obtain eligibility and benefit details through the Interactive Voice Response (IVR) phone system by calling 888-349-3706 or 888-898-0070. The IVR furnishes the same basic eligibility and benefit information as a Customer Advocate provides. Our Customer Advocates will continue to be available for additional assistance and more complex benefit information.
To learn more about online solutions, refer to the Tools page in the Education and Reference section of our Provider website. For IVR navigational assistance, refer to the Eligibility and Benefit Caller Guide located in the Claims and Eligibility section of our website.
Note: To verify eligibility and benefits requests via phone for Medicare Advantage members, refer to the number on the member’s ID card.
Checking eligibility and/or benefit information 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 applicable on the date services were rendered. If you have any questions, please call the number on the member’s ID card.
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 Availity. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.