News and Updates
• Going Green with EDI 8/15/08 • Faster Navigation of the Interactive Voice Response System 8/15/08 • HCSC Moves to Acquire MEDecision 8/12/08 • Availity Training Webinars Now Available 8/11/08 • Taxonomy Codes – What They Are and How They Are Used 8/8/08 • Prime Therapeutics Has New Prescription Drug Supplier 8/8/08 • Annual Provider Satisfaction Survey 7/25/08 • NPI Billing Alert – Providers Belonging to a Group 7/23/08 • Notification of Bundling Logic Changes 7/16/08
Electronic Commerce
•Electronic Commerce Alerts •Electronic Transactions •EDI Format Specifications •EFT/ERA FAQs •EFT/ERA Forms •Availity LLC •HealthXNet •HIPAA
Claim Filing
• CMS-1500 Tutorial • A Guide for Completing the CMS-1500 Form • UB04 User Guide • Timely Claim Filing guidelines • BlueCard Claim Filing instructions • Appeals Process information
Pharmacy
• Drug List - Alphabetic • Drug List - Therapeutic Class • Drug List Limitations, Exclusions, and Prior Authorization Criteria • New Mexico Comparative Formulary • Specialty Pharmacy Program
Provider Network
• Online Provider Finder • Printable Provider Directories • Network Overview
Provider Tools
• Obesity Management Tool Kit Web Site • Hospital Comparison Tool
Provider Library
• Provider Reference Manual •2008 Provider Reference Manual Changes • Medical Policies • Draft Medical Policies • Newsletter (Blue Review) • Forms • National Provider Identifier • Interactive Voice Response (IVR) System •Become a BCBSNM Provider
UM/QI/Medical Management
• Preventive Health Guidelines: Adult, Children, and Prenatal • Clinical Practice Guidelines: Asthma, Diabetes, Hypertension, Depression • Blue Care Connection Disease Management Programs • Diabetes Guidelines and Reference Materials • Prior Authorization/Approval • Case Management Services
Medicaid Utilization Review
• About Medicaid UR • Training • Review Types • Forms • FAQs • Contact Medicaid UR
Blue Medicare PPO
• Contacts • Overview • Alerts • Claims • Preauth Requirements • Provider Resources
Contact Us
• BCBSNM Contact Information for Providers
*Note: Some of the information above for BCBSNM providers is available in Adobe Acrobat PDF format. You will need Adobe Acrobat Reader to view the information; this can be downloaded free of charge from Adobe's site.
