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Updates Made to the Blues Provider Reference Manual

November 19, 2019

The Blues Provider Reference Manual (PRM) has been updated, effective Jan. 1, 2020.

Changes to the PRM include, but are not limited to, the following sections:

  • 10 – Preauthorization
  • 11 – Utilization, Case, Population Health, and Condition & Lifestyle Management
  • 12 – Behavioral Health Services
  • 15 – Grievance Process for Participating Providers
  • 16 – Credentialing
  • 17 – Quality Improvement

The updated PRM will be available for review on the Provider Reference Manual webpage at bcbsnm.com/provider on or before Dec. 1, 2019. Blue Cross and Blue Shield of New Mexico reminds providers to review the PRM for all changes.