Tools
At Blue Cross and Blue Shield of New Mexico (BCBSNM), we are committed to providing support to physician practices. We’ve designed tools that health care providers find useful. Whether doing research or streamlining billing, these tools can help you evaluate costs, save time, improve service and more.
Blue Distinction®
BCBSNM, in partnership with the Blue Cross and Blue Shield Association, has developed Blue Distinction Centers. Each Center has been selected through a rigorous, evidence-based, objective selection criteria established with input from medical experts and organizations.
Blue Distinction is a nationwide program that will create an unprecedented level of healthcare transparency with two goals: engaging consumers to enable more informed healthcare decisions and collaborating with providers to improve quality outcomes and affordability.
To learn more about the program, selection criteria, and designated centers in each state, visit Blue Distinction for Providers
.
Bridges to Excellence®
BCBSNM is licensed as a sponsor of the Bridges to Excellence
Diabetic Care Recognition program and Cardiac Care Recognition programs. Learn More
CareCost EstimatorSM
The Availity® CareCost Estimator tool is an online member liability estimator that can help professional providers estimate a patient's potential out-of-pocket costs in real-time for office and outpatient services provided to BCBSNM members. Learn More
CareProfile®
The CareProfile tool uses claim-based information to provide you with a consolidated view of a patient's health care history at the point of care. Learn More
Claim Inquiry Resolution
The Claim Inquiry Resolution tool allows you to communicate online with our customer advocates in some situations where previously a call or letter was required. Learn More
Claim Research Tool
The Claim Research Tool offers enhanced, real-time claim status functionality to help you manage and resolve your BCBSNM claims. Learn More
Clear Claim Connection
Clear Claim Connection is a web-based code auditing reference tool that mirrors BCBSNM edits (i.e., unbundling, mutually exclusive, and incidental). Learn More
Electronic Refund Management
Electronic Refund Management is an online tool that can help simplify your overpayment reconciliation and related processes. Learn More
iEXCHANGE
iEXCHANGE is a Web-based application that supports an automated precertification process for BCBSNM. iEXCHANGE supports the direct submission and processing precertifications by facilities within New Mexico. Learn More
OptiNet® Assessment Tool
OptiNet is an online assessment tool to collect modality-specific data from imaging providers. Learn More
