Overpayment Recovery Process for Contracted Providers
Blue Cross and Blue Shield of New Mexico (BCBSNM) payment processes were updated on Jan. 1, 2020. You may have noticed changes in the number of payments you receive from us and in our overpayment recovery process.
What has changed?
Multiple payments: You may be used to receiving a consolidated payment from BCBSNM that addresses multiple claims for members who belong to different employer groups. Now our employer groups have the choice to not participate in this type of reimbursement. This means that you may now be receiving reimbursements from us in multiple payments.
Overpayment recovery: Employer groups may also choose not to participate in offsetting overpayments from consolidated payments that address multiple claims from members who belong to different employer groups. This means that when we attempt to recover overpayments, you may have to send in a check for certain overpayments. Instructions for submitting a refund will be in the request letter we send you.
If you have any questions, please call our Financial Operations at (844) 866-BLUE.