Ombudsman Program

What is an Ombudsman?

An ombudsman (or “ombudsman specialist”) helps resolve issues for Medicaid members. They explore problems and deal with them fairly. They can also speak up for those who can’t speak for themselves. There is no cost to Turquoise Care members to get help from an ombudsman.

 Why Contact an Ombudsman?

An ombudsman can help you and your family:

• Review and address concerns about services.
• Receive the benefits of your Turquoise Care health plan.
• Understand your rights and responsibilities.
• Look into and address member issues without taking sides. 
• Work to resolve your issues following New Mexico's Medicaid guidelines and using Blue Cross and Blue Shield of New Mexico resources.
• Understand the appeals and grievance process.

Being able to work with an ombudsman empowers members to take a self-directed approach to care.