• What are the most commonly used provider forms and their uses?
• How do I join the BCBSNM provider networks?
• How do I make changes to my contact information?
• How do I make changes to my name or tax identification number?
• How do I find information about BCBSNM's code editing tool, Clear Claim Connection (C3)?
• What does the BlueSalud member ID card look like?
• Whom do I contact if I have questions about the BlueSalud network?
• How do I automate my electronic claims payments?
• Whom do I contact if I have questions about claims, contracts, or preauthorization?
• How do I change my existing provider record information?
• How do I get a National Provider Identifier (NPI)?
• How can I avoid claim payment delays?
• How do I use the Interactive Voice Response (IVR) system?
• Where can I find information on the BlueSalud product?
What are the most commonly used provider forms and their uses?
The eight most commonly used provider forms and their uses are:
- Coordination of Benefits Questionnaire
- Provider Refund Form
- Provider Request for Appeal on Behalf of a Member
- Provider Request for Claim Review
- Request to Establish or Revise a Non-Contracted Facility Record
- Request to Establish or Revise a Non-Contracted Provider Record
- Rx Drug PrimeMail Fax Form (must be faxed from a physician's office)
- Rx Drug Prior Authorization Form
How do I join the BCBSNM provider networks?
Fill out a Professional or Facility application for participation.
Mail the application and the requested documentation to:
BCBSNM
Attn: Network Services (HQ-3)
P.O. Box 27630
Albuquerque, NM 87125-7630
How to join the BCBSNM provider networks
How do I make changes to my contact information?
Complete the Update Your Contact Information icon on the Provider homepage.
How do I make changes to my name or tax identification number?
Follow the instructions on the Application for Legal Status Change 
.
How do I find information about BCBSNM's code editing tool, Clear Claim Connection (C3)?
Clear Claim Connection* (C3) is a Web-based code auditing reference tool that mirrors BCBSNM edits (i.e., unbundling, mutually exclusive, and incidental).
C3 is designed to make BCBSNM payment policies, rules, and edit rationale easily accessible for viewing via the Web site. C3 can increase your administrative efficiency by reducing manual inquiries, claims appeals, and misunderstandings regarding BCBSNM's edits.
Physicians and their office staff, registered with Availity, can review the claim payment methodology and reimbursement policies behind coding edits. While on the Availity Web site, look for Claims Management/Research Procedure Code Edit. Visit Availity** to sign up if you are not currently an Availity user.
There will be demonstrations and a question/answer session integrated into future provider education webinars. Please see the provider education page to view webinar information.
What does the BlueSalud member ID card look like?
A sample BlueSalud member ID card is available by going to BlueSalud, then Resources.
Whom do I contact if I have questions about the BlueSalud network?
For questions about the BlueSalud network, call Angela Sanchez-Caldwell at 505-816-2038.
How do I automate my electronic claims payments?
Complete the HCSC Electronic Funds Transfer Agreement.
Send the completed forms to:
Health Care Service Corporation
Electronic Commerce Services Unit - 25th Floor
300 East Randolph Street
Chicago, Illinois, 60601
Please see ERA/EFT/EPS FAQs in Electronic Commerce for answers about electronic claims filing.
Whom do I contact if I have questions about claims, contracts, or preauthorization?
Go to Contact Us on the Provider homepage.
How do I change my existing provider record information?
Non-contracted providers can use the forms Request to Establish or Revise a Non-Contracted Facility Record or Request to Establish or Revise a Non-Contracted Provider Record located in the Forms section of the Provider Library.
Contracted or non-contracted providers can also use the Update Your Contact Information icon on the Provider homepage.
Note: Please allow up to 30 days for changes to take place.
How do I get a National Provider Identifier (NPI)?
1. Apply online**
2. Apply by mail. Call or email the NPI Enumerator to request an application form. Send the completed application to:
NPI Enumerator
P.O. 6059
Fargo, ND 58108-6059
3. Apply by third party. With your permission, an organization may submit your application in an electronic file. This could mean that a professional association or perhaps a health care provider who is your employer could submit an electronic file containing your information and the information of other health care providers.
Type 1 – Individual
Type 2 – Organizational
Contact Information
Contact Fox Systems directly with questions about processing an NPI application.
Telephone:
1-800-465-3203
1-800-692-2326 (TTY)
How can I avoid claim payment delays?
Always include the following information on your claims:
- Member's three-letter alpha prefix and the identification number (e.g. YIF1234567)
- Policy group number
- Onset date
- Physician's and/or supplier's name, address, telephone number
- Physician's and/or supplier's NPI
View Tips for Preventing Claim Delays
How do I use the Interactive Voice Response (IVR) system?
Go to Interactive Voice Response System in the Provider Library. There you will find:
- IVR Available Hours
- Guidelines
- IVR Benefit Collection Assistance Sheet
- IVR Helpful Hints and Tips
- IVR Caller Guide
Where can I find information on the BlueSalud product?
Resources, forms, contact information, and more, can be found on the BlueSalud Provider Resources page.
*Clear Claim Connection, ClaimCheck and CodeReview are trademarks of McKesson Information Solutions, Inc., an independent contractor.
**We do our best to ensure that the information on the Web sites shown above is useful, but can't be responsible for the content of those sites or any information you may take from them (please read our legal disclaimer). When you click on a site link above, it will open in a new window so that you can explore that site without having to leave here. When you are through visiting the other site, you can close that window and return to the BCBSNM site.
