Important Update: Preauthorizations by Other MCOs for Members Who Transitioned to Blue Cross Community CentennialSM on Jan. 1, 2019
Preauthorizations were approved by other Centennial Care 1.0 MCOs for services to be furnished to members after commencement of Centennial Care 2.0 on Jan. 1, 2019. Some of these members transitioned to Blue Cross Community Centennial on Jan. 1, 2019 with approved authorizations for future services in place (Open Authorizations). Blue Cross and Blue Shield of New Mexico (BCBSNM) intends to honor these Open Authorizations to the full extent of HSD requirements but has experienced a delay in uploading them to BCBSNM’s systems. So that claims for services subject to Open Authorizations are not denied for lack of preauthorization, BCBSNM will apply a manual review process until a systems solution is implemented.
If you have questions about this communication or regarding the disposition of a claim for services that were preauthorized by another MCO for a Blue Cross Community Centennial member, please contact BCBSNM Provider Customer Service at 800-693-0663.