Blue Review — Provider Newsletter

Our Blue Review provider newsletter is released monthly so that you and your staff have the latest news on claims and billing, federal mandates, medical policies, condition management programs, practice guidelines, formulary/drug list updates, Medicaid, BlueCard, and educational webinars.

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November 2024 — Read these articles and more...

  • Risk Identification and Outreach Program Supports Member Safety
  • Updates Coming to Behavioral Health Substance Abuse Criteria for Utilization Management
  • Submit Itemized Bills or Medical Records for Additional Facility Claims
  • Prior Authorization Requirements Are Changing for Some Commercial and Turquoise Care Members
  • Billing and Documentation Guidelines for Urine Drug Tests Are Retired
  • Remind Our Members That the Flu Vaccine Can Reduce Risks
  • Encourage Annual Eye Exams for Members with Diabetes
  • Care Coordination May Help Our Members after Hospital Discharges
  • Code Effectively to Earn Additional Incentive Payments on Medicare Advantage Claims
  • Members May Pay Drug Costs Monthly with New Medicare Prescription Payment Plan
  • Check ID Cards for New Coupe Health Plan Members
  • Select Self‑Administered Drugs Moving to Pharmacy Benefit
  • Pharmacy Program Quarterly Update Changes – Part 2
  • Clinical Payment and Coding Policy Updates
  • Members May Request Fewer Personal Care Service Hours
  • Personal Care Service Agencies Must Meet Caregiver Requirements

 

October 2024 — Read these articles and more...

  • Acquisition of Cigna Healthcare Medicare Business in 2025
  • Utilization Management Expanding to Include Site of Care Review of Advanced Imaging for Some Commercial Members
  • Use the Updated Claims Referral Form for American Indian/Alaska Native Limited Cost-Share Plans
  • Submit Paper Commercial Claims to Correct PO Box to Avoid Delays
  • ClaimsXtenTM Quarterly Update
  • Breast Cancer Screening Begins at Age 40
  • In‑home Test Kits Help Our Members Manage Their Kidney Health
  • Register for a Coding Webinar on Coagulation Defects and Other Hematological Disorders
  • Clinical Payment and Coding Policy Updates
  • Provider Reference Manual Updates
  • Health Care Authority Creates a Payment Reform for Primary Care Providers
  • Reporting Requirements for Providers Supplying Diabetic Supplies, Equipment and Prescriptions

 

September 2024 — Read these articles and more...

  • Physician Performance Insights Reports Are Now Available
  • Clinical Payment and Coding Policy Updates
  • Shared Decision‑Making Aids Can Help Guide Care Choices
  • Earn Continuing Education Credit at Maternal Mental Health Webinar
  • Register for Webinars on Coding for Cancers, Stroke and Heart Failure
  • Encourage Medicare Members to Respond to Health Outcomes Survey
  • Facility‑Based Providers Have a Credentialing Requirement
  • Abiraterone Drug Coverage Changes for Many Commercial Members as of Oct. 1, 2024
  • 30‑Day Supply Limit: Select Commercial Members Have New Pharmacy Benefit for GLP‑1 or Anti‑Obesity Drug Therapy
  • Pharmacy Program Quarterly Update Changes Effective Oct. 1, 2024 – Part 1
  • Medical Policy Updates
  • Keep Your Enrollment Status with New Mexico Medicaid Updated
  • New EPSDT Clinical Practice and Billing Guideline Is Available
  • Learn about Contracting with Turquoise Care
  • Employees Provide Needed Supplies to New Mexico Students

 

August 2024 — Read these articles and more...

  • Required Annual Cultural Competency Training Available Virtually
  • Has Your Information Changed? Update Us and NPI Registry
  • Proper Billing for Supplies for Transcutaneous Electrical Nerve Stimulation Units
  • Prior Authorization Updates for Commercial Members Effective Oct. 1
  • Check Prior Authorization Requirements for Procedure Codes through Availity® Essentials or Our IVR System
  • Clinical Payment and Coding Policy Updates
  • Breast Cancer Screening for Members Ages 40 to 74
  • Provider Finder® to Rank Providers to Help PPO Members Find Care
  • Prior Authorization Updates for Medicare Advantage Effective Oct. 1
  • Medicare Providers May Treat Blue Cross Group Medicare Advantage Open Access (PPO)SM Members
  • Supporting EPSDT Compliance in School-Based Health Centers

July 2024 — Read these articles and more...

  • New Coupe Health Plan: Update Your Member Records
  • Updates made to the Provider Reference Manual
  • Cultural Awareness Webinars: No-Cost Continuing Education Credit
  • Coming Soon — New Learning & Training Center in Availity® Essentials
  • Member Rights and Responsibilities
  • Provider Rights and Responsibilities
  • Prior Authorization Requests May Be Needed Due to Pharmacy Claims Processing Error
  • Clinical Payment and Coding Policy Updates
  • Our Revised Clinical Payment and Coding Policy for Anesthesia Services Is Now Effective Jan. 1, 2025
  • Coding Update: Reimbursement Change for Consultation Services
  • Access MCG Care Guidelines Clinical Criteria via Availity
  • Encourage Routine Vaccines and Well-Care Visits for Children and Teens
  • In-Home Test Kits for Colorectal Cancer Screening
  • Physician Performance Insights Reports Coming Soon from PEAQSM
  • Requests for Behavioral Health Documentation for Medicaid Members
  • 2024 NM Annual NDC Drug Fee Schedule Impact and Timeline
  • GLP-1 New to Therapy Optional Benefit Program Available for Select Commercial Members
  • Notify Us If You Opt Out of Medicare
  • New Mexico Medicaid Extends Support to Members Affected by Ruidoso Evacuations
  • New Mexico Medicaid Shares Update on Provider Rates
  • Resources for Providers Needing Language Assistance for Members
  • Keep Your Enrollment Status with New Mexico Medicaid Updated
  • Billing Tips for Midwife Providers
  • Prenatal and Postpartum Care Coordination Changes for Medicaid Members

June 2024 — Read these articles and more...

  • Reminder: Use New Mailing Address
  • Important Updates to Manage My Organization in Availity® Essentials
  • New Mexico House Bill 27: Breast Exam Health Coverage
  • Electronic Claim Review and Ensuring the Correct Use of our Claim Review Form
  • ClaimsXtenTM Quarterly Update Effective Aug. 19, 2024
  • Helping Our Members Manage Diabetes
  • Updated PEAQSM Methodology Is Now Available
  • Clinical Payment and Coding Policy Updates
  • Behavioral Health Consultations During Hospitalization Can Improve Outcomes
  • Pharmacy Program Quarterly Update Changes Effective July 1, 2024 — Part 1
  • Closing Gaps in Care for Group Medicare Advantage (PPO) Members
  • RSVP for the 2024 Turquoise Care Provider Training Sessions
  • Medicaid Transition to Turquoise Care on July 1, 2024
  • Turquoise Care Provider Reference Manual

May 2024 — Read these articles and more...

  • Updates made to the Provider Reference Manual
  • Reporting Requirements for Providers Supplying Diabetic Supplies, Equipment and Prescriptions
  • Avoid Directory Suppression: Update your Directory Information such as Accepting New Patients
  • Late and Added Charges Must Be Submitted as a Corrected Claim
  • 2024 Billing/Documentation Guidelines for Urine Drug Tests
  • Prior Authorization Updates
  • Coding Webinars: Arrhythmias and Rheumatoid Arthritis
  • Supporting Maternal Quality Care
  • Clinical Payment and Coding Policy Updates
  • Filing Claims for Behavioral Health Services — Use the Correct Place of Service Code
  • Pharmacy Program Quarterly Update Changes Effective April 1, 2024 — Part 2
  • Updates Made to the Medicare Advantage Provider Reference Manual
  • Prior Authorization Updates for Medicare Advantage
  • Updates Made to the Provider Reference Manual for Blue Cross Community Centennial
  • 2023 Medical Record Review
  • Updated: BCBSNM New Process Regarding Legal Responsible Individuals as Caregivers

April 2024 — Read these articles and more...

  • Change Healthcare Cybersecurity Incident Impact
  • ClaimsXten™ Quarterly Update Effective June 17, 2024
  • See Our Revised Clinical Payment and Coding Policy for Anesthesia Services
  • Clinical Payment and Coding Policy Updates
  • Caring for Substance Use Disorders
  • Webinar on Coding for Medicare Advantage Annual Wellness Visits
  • Medicare Advantage Coverage of Skilled Nursing Care and Skilled Therapy Services
  • RSVP for 2024 Annual Medicaid Provider Training Sessions
  • EPSDT Insights & Provider Participation
  • Increasing Access to Health Care One Care Van Visit at a Time
  • BCBSNM Breaks Ground on Blue Door Neighborhood CenterSM

March 2024 — Read these articles and more...

  • Reminder: Update Your Records with New Mailing Addresses for Paper Claims
  • Updates made to the Provider Reference Manual
  • Federal Employee Program Updates to Prior Approval Requirements and Benefits
  • Closing Gaps in Colon Care
  • Clinical Payment and Coding Policy Updates
  • Follow-up Care for Mental Health
  • Avoiding the Inappropriate Use of Antipsychotic Medication in Anxiety Disorders
  • Pharmacy Program Quarterly Update Changes Effective April 1, 2024 — Part 1
  • Medicare Advantage HEDIS Records Collection through June 2024
  • Updates Made to the Blue Cross Community Centennial Provider Reference Manual
  • Blue Cross Community Centennial Members Rate Their Experience
  • Blue Cross Community Centennial Quality Improvement Program
  • New Mexico Medicaid Team Provides Prenatal Outreach to High-Risk Mothers

February 2024 — Read these articles and more...

  • Changes Coming to Claim Inquiry Resolution — High-Dollar, Pre-Pay Reviews Only
  • Provider Onboarding Process Update
  • Blue Cross and Blue Shield Federal Employee Program® HEDIS® Records: Collecting February through April 2024
  • Join Our Quality Improvement Committee: Provider Opportunity at BCBSNM
  • 2023 Annual HEDIS Medical Record Review Begins February 2024
  • Prior Authorization Updates
  • ClaimsXtenTM Quarterly Update Effective April 15, 2024
  • Coding Webinars: Major Depressive Disorder and Annual Wellness Visits
  • Utilization Management: How to Avoid Delays and Denied Claims
  • Managing Antidepressant Medication
  • Supporting Healthy Hearts
  • Clinical Payment and Coding Policy Updates
  • Appropriate Use of Opioids Program to be Retired January 2024
  • Pharmacy Program Quarterly Update Changes Effective Jan. 1, 2024 — Part 2
  • Prior Authorization Updates for Medicare
  • Centers for Medicare and Medicaid Services guidelines for Availability and Access Standards to Care for Medicare Advantage Members
  • BCBSNM New Process Regarding Legal Responsible Individuals as Caregivers
  • New Mexico Kids Matter Receives Grant from BCBSNM to Support Teens in Foster Care

January 2024 — Read these articles and more...

  • Reminder: Update Your Records with New Mailing Addresses for Paper Claims
  • Updates made to the Provider Reference Manual
  • Advisory on Telemedicine Services — Using Place of Service Codes on Commercial Claims
  • Prior Authorization Updates
  • Three New ClaimsXtenTM Rules to be Implemented March 2024
  • Reminder: See Updates to Claim Editing Changes for Emergency Department Services
  • Clinical Payment and Coding Policy Updates
  • Monitoring Children Using ADHD Medication
  • Remind Our Members about Cervical and Breast Cancer Screenings
  • Oral Oncology Pharmacy Network Transitioned to IntegratedRxTM
  • BCBSNM’s Approach to Managing GLP-1 Agonist Medications
  • Updates Made to the Blue Cross Medicare Advantage Provider Reference Manual
  • Prior Authorization Updates for Medicare
  • Patients in the Qualified Medicare Beneficiary Program Should Not Be Billed
  • Hospitals Must Provide Medicare Outpatient Observation Notice
  • Update Your Records: New Medicare Open Access PPO Members and ID Cards
  • Updates Made to the Blue Cross Community Centennial Provider Reference Manual
  • Zuni Youth Enrichment Project Receives Grant from BCBSNM to Improve Health Outcomes for Zuni Residents

  • 2023

    December 2023 — Read these articles and more...

    • Updates Made to the Provider Reference Manual
    • Chronic Kidney Disease Management Strategies for Primary Care Providers
    • Reimbursement Rate Update for Some Commercial ABA Codes
    • New Email Address for Electronic Commerce Services
    • See Updates to Claim Editing Changes for Emergency Department Services
    • Encourage Annual Eye Exams for Members with Diabetes
    • Clinical Payment and Coding Policy Updates
    • Training Resources for Behavioral Health Care
    • Pharmacy Program Quarterly Update Changes Effective Jan. 1, 2024 — Part 1
    • Updates Made to the Blue Cross Medicare Advantage Provider Reference Manual
    • Medical Records Reminder for Out-of-Area Medicare Advantage Members
    • Blue Cross Medicare Advantage Dual Care PlusSM 2022 Program Summary
    • Blue Cross Medicare Advantage Dual Care Plus Preferred 2022 Program Summary
    • Rate Increase for After Hours/Weekend Well Child Visits
    • Updates Made to the Blue Cross Community Centennial Provider Reference Manual
    • BCBSNM Will Open a Blue Door Neighborhood Center in the South Valley

     

    November 2023 — Read these articles and more...

    • Provider Finder® to Highlight ‘Top Performing Physicians’
    • Join Us for a Webinar on Coding for Vascular Disease
    • New CPT® Codes for COVID-19 Vaccines and Vaccine Administration
    • Clinical Payment and Coding Policy Updates
    • Coordinating Care after Hospital Discharges to Help Reduce the Chances of Readmissions
    • What You Need to Know About the Flu Season
    • Remember: New Enhancements for Behavioral Health Preservice Review Requests
    • BlueApprovRSM Now Accepts Recommended Clinical Reviews for Behavioral Health — Attend a Training
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Oct. 1, 2023 – Part 2
    • Musculoskeletal Category Expansion, Code Removals and other Prior Authorization Updates, Effective Jan. 1, 2024
    • Medical Oncology, Radiation Oncology Care Category Removal from eviCore and other Prior Authorization Updates for Medicare Jan. 1
    • Medicare Advantage Members to Transition to BCBSNM Kidney Care Program
    • RSVP for 2023 Annual Medicaid Provider Training Sessions
    • BCBSNM Will Implement a New Process for Member-Driven PCS Hour Decreases
    • Temporary Economic Recovery Payment Increase for Home and Community Based Services — LOD #79-1
    • Expiration of the Public Health Emergency — Prior Authorization for ABA Services
    • Blue Cross and Blue Shield of New Mexico Teams Up With National Fitness Campaign to Bring Outdoor Fitness Courts Across New Mexico

     

    October 2023 — Read these articles and more...

    • BCBSNM Receives Notification of Intent to Award Turquoise Care Contract
    • New Mailing Addresses for Paper Claims
    • Updates made to the Provider Reference Manual
    • ClaimsXtenTM Quarterly Update Effective Dec. 4, 2023
    • Inpatient DRG claims for patients transferred early will be paid according to CMS’ transfer policy
    • Reminder for Billing Point-Of-Use Convenience Kits
    • Clinical Payment and Coding Policy Updates
    • Updates to Clinical Practice and Preventive Care Guidelines
    • BlueApprovRSM Now Accepts Recommended Clinical Reviews — Attend a Training
    • Supporting Quality Care During Breast Cancer Awareness Month
    • See New Enhancements for Behavioral Health Pre-service Reviews
    • Select Medication List to be Discontinued
    • Updates Made to the Blue Cross Medicare Advantage Provider Reference Manual
    • Current Procedural Terminology (CPT®) Codes Updated for Prior Authorization for Medicare Oct. 1
    • Survey Assesses Medicare Advantage Members’ Health Outcomes
    • Updates Made to the Blue Cross Community Centennial Provider Reference Manual 
    • Blue Cross and Blue Shield of New Mexico Awarded NCQA Long-Term Services and Support Distinction

     

    September 2023 — Read these articles and more...

    • Transition from required Prior Authorization to Recommended Clinical Review Effective Sept. 18, 2023
    • Reporting On-Demand via Availity® Essentials is Now Named Provider Claim Summary
    • Shared Decision-Making Aids Can Help Guide Care Choices
    • Claim Editing Changes for Emergency Department Services Coming Nov. 1, 2023
    • Submitting Claims for Infertility Services
    • Clinical Payment and Coding Policy Updates
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Oct. 1, 2023 — Part 1
    • Medical Records Reminder for Out-of-Area Medicare Advantage Members
    • Expiration of the Public Health Emergency
    • New Mexico Medicaid Provider Engagement Forum

     

    August 2023 — Read these articles and more...

    • Updates made to the Provider Reference Manual
    • Webinar on Coding for Morbid and Severe Obesity
    • Introducing Claim Reconsideration Requests via Availity® Essentials
    • Prior Authorization Codes Updated, Effective Oct. 1, 2023
    • PEAQSM Physician Performance Insight Reports are Coming Soon
    • In-Home Test Kits for Colorectal Cancer Screening
    • Statin Therapy for Patients with Cardiovascular Disease and Diabetes
    • See Our Revised Preventive Services Clinical Payment and Coding Policy Effective July 1, 2023
    • Clinical Payment and Coding Policy Updates
    • Direction from Centers for Medicare & Medicaid Services (CMS) regarding enrollment requirements for prescribing pharmacists or pharmacy providers under Medicaid
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective July 1, 2023 — Part 2
    • Current Procedural Terminology (CPT®) Codes Updated for Prior Authorization for Medicare Oct. 1

     

    July 2023 — Read these articles and more...

    • Letter of Direction (LOD) #85 — Community Benefit Provider Audits
    • Updates made to the Provider Reference Manual
    • Webinars on Cross-Cultural Care Offer Continuing Education Credit
    • Blue Community HMO NetworkSM (CNN) — Individual On and Off Exchange Plans
    • New Availity® Eligibility & Benefits Experience
    • Provider Access and Availability Survey
    • Member Rights and Responsibilities
    • Provider Rights and Responsibilities
    • ClaimsXtenTM Announces Software Version Upgrade
    • Catch Up on Routine Vaccines and Well-Child Visits
    • Clinical Payment and Coding Policy Updates
    • Prior Authorization Codes Updated, Effective July 1
    • Current Procedural Terminology (CPT®) Codes Updated for Prior Authorization for Medicare and Medicaid Programs, July 1
    • Blue Cross Medicare Advantage Dual Care Plus (HMO SNP)SM 2021 Program Summary
    • Medicare Providers May Treat Medicare Advantage Flex and Group Medicare Advantage Open Access PPO Members

     

    June 2023 — Read these articles and more...

    • PEAQSM Provider Performance Insights Coming Soon
    • BlueApprovRSM Expedites Medical Surgical, Pharmacy and Behavioral Health Prior Authorization — Attend a Training
    • Coverage for Telemedicine Services when the Public Health Emergency Ends May 11
    • Updates made to the Provider Reference Manual
    • Earn Continuing Education Credit at a Webinar on Avoiding Inappropriate Antibiotic Use
    • ClaimsXtenTM Quarterly Update Effective August 21, 2023
    • 2023 NM Annual NDC Drug Fee Schedule Impact and Timeline
    • Helping Our Members Manage Diabetes
    • See our New Clinical Payment and Coding Policy for Outpatient Facility Services that Overlap During an Inpatient Stay
    • Clinical Payment and Coding Policy Updates 
    • Members Can Now Access Network of Pharmacies at Accredited Cystic Fibrosis Treatment Centers
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective July 1, 2023
    • Updates Made to the Blue Cross Medicare Advantage Provider Reference Manual
    • Medical Records Reminder for Out-of-Area Medicare Advantage Members
    • Updates Made to the Blue Cross Community Centennial Provider Reference Manual

     

    May 2023 — Read these articles and more...

    • BlueApprovRSM Expedites Medical Surgical, Pharmacy and Behavioral Health Prior Authorization — Attend a Training
    • Updates made to the Provider Reference Manual
    • Webinar on Coding for Chronic Kidney Disease
    • Annual Regulatory Survey of BCBSNM Provider Directories
    • Prior Authorization Codes Updated, Effective July 1, also watch for Medical Oncology Portal Enhancements
    • Current Procedural Terminology (CPT®) Codes Updated for Prior Authorization for Medicare and Medicaid programs, July 1
    • New Support Program for Members with Kidney Disease
    • Track Care Visits During and After Pregnancy
    • See our New Three-day Payment Policy for Outpatient Services Prior to an Inpatient Admission
    • Clinical Payment and Coding Policy Updates
    • Behavioral Health Consultations During Hospitalization Can Improve Outcomes
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective April 1, 2023 — Part 2
    • 2022 Medical Record Review

     

    April 2023 — Read these articles and more...

    • AIM Specialty Health Changes Its Name to Carelon Medical Benefits Management
    • BCBSNM Engaged Hospital Service Corporation for Site Visits
    • Earn Continuing Education Credit through Webinar on Opioids
    • See Changes to our Existing Inpatient Readmission Policy for Some Commercial Members
    • Monitoring Children Using ADHD Medications
    • Caring for Substance Use Disorders
    • Screening and Follow-Up Care for Maternal Mental Health
    • New for 2023: Specialty Pharmacies Added In-Network
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective January 1, 2023 — Part 2

     

    March 2023 — Read these articles and more...

    • New Blue ApprovRSM Expedites Some Prior Authorizations — Attend a Training to Learn More
    • Updates made to the Provider Reference Manual
    • Earn Continuing Education Credit through Webinar on Bipolar Disorder
    • Cultural Awareness Webinars: Earn Continuing Education Credit
    • Verify Your Directory Details Every 90 Days
    • Provider Onboarding Form Requirement
    • Closing Gaps in Colon Care
    • Clinical Payment and Coding Policy Updates
    • Quality Care: Screening for Depression
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective April 1, 2023 — Part 1
    • Help Close Gaps in Care for Group Medicare Advantage Members
    • Survey to Assess Medicare Advantage Members’ Experiences
    • Updates Made to the Blue Cross Medicare Advantage Provider Reference Manual
    • COVID-19 Public Health Emergency Ending
    • New Mexico Human Services Department Issues Supplement #22-12
    • Updates Made to the Blue Cross Community Centennial Provider Reference Manual

     

    February 2023 — Read these articles and more...

    • FEP® Annual Medical Record Data Collection for Quality Reporting — HEDIS®
    • Updates made to the Provider Reference Manual
    • Prior Authorization Codes Updated, Effective April 1
    • Current Procedural Terminology (CPT®) Codes Updated for Prior Authorization for Medicare and Medicaid programs, April 1
    • ClaimsXtenSM Quarterly Update Effective April 17, 2023
    • Supporting Heart Health Equity
    • Predetermination is now Recommended Clinical Review
    • Clinical Payment and Coding Policy Updates
    • Inflation Reduction Act to Impact Insulin and Vaccine Costs for Medicare Members
    • Blue Cross Medicare Advantage Dual Care Plus (HMO SNP)SM 2020 Program Summary
    • Updates Made to the Blue Cross Medicare AdvantageSM Provider Reference Manual
    • Updates Made to the Blue Cross Community CentennialSM Provider Reference Manual

     

    January 2023 — Read these articles and more...

    • Prior Authorization Codes Updated, Effective January 1
    • Current Procedural Terminology (CPT®) Codes Updated for Prior Authorization for Medicare programs
    • Cervical and Breast Cancer Screenings
    • Clinical Payment and Coding Policy Updates
    • Patients in the Qualified Medicare Beneficiary Program Should Not Be Billed
    • Hospitals Must Provide Medicare Outpatient Observation Notice
    • Centennial Care Behavioral Health Screening Incentive Program
    • Blue Cross Community Centennial Members Rate Their Experience
    • Our Blue Cross Community Centennial Quality Improvement Program

  • 2022

    December 2022 — Read these articles and more...

    • New Laboratory Management Program Training Sessions
    • 2022 Annual HEDIS® Medical Record Review Begins February 2023
    • Prior Authorization Codes Updated, Effective January 1
    • Continuity of Care is Driven by Prompt Communication Upon Hospital Discharge
    • Importance of Early and Timely Intervention for Pre- and Postpartum Care to Help Improve Health Outcomes
    • Keeping an Eye on Improved Provider Collaboration
    • Statin Therapy for Patients with Cardiovascular Disease and Diabetes
    • New Tool Improves Behavioral Health Prior Authorization — Attend a Training
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Jan. 1, 2023 — Part 1
    • Help Close Gaps in Care for Group Medicare Advantage Members
    • RSVP for 2022 Annual Medicaid Provider Training Sessions

     

    November 2022 — Read these articles and more...

    • New Laboratory Management Program to Begin Jan. 1, 2023
    • Postponed: Use Our Automated Phone System to Request Prior Authorization for FEP® Members
    • Confirm Medical Record Receipt Status Online for Prior Authorization Requests
    • Prior Authorization Codes Updated, Effective January 1
    • Current Procedural Terminology (CPT®) Codes Updated for Prior Authorization for Medicare programs
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Oct. 1, 2022 — Part 2
    • What You Need to Know About the Flu Season
    • Diabetes Screening for People Using Antipsychotic Medications
    • Submitting Unlisted or Miscellaneous Codes: Billing Guidelines and Reminders

     

    October 2022 — Read these articles and more...

    • New Tool to Verify Credentialing Information
    • Reminders When Using the Claims Inquiry Resolution (CIR) Tool
    • Coverage Information for Monkeypox
    • Reminder: Verify Your Directory Details Every 90 Days
    • Short Term Complications of Diabetes Admission Questionnaire
    • Health Equity and Social Determinants of Health: New Resources for Providers
    • Earn Continuing Education Credit through Webinar on Suicide Prevention
    • Addressing Disparities in Breast Cancer for Black Women
    • ClaimsXtenTM Quarterly Update Effective Dec. 5, 2022
    • We’re Reducing Prior Authorization Requirements for Certain Applied Behavioral Analysis (ABA) Codes for Some Commercial Members, in some instances
    • Coronavirus Public Health Emergency Ending
    • Required Cultural Competency Training Available Online
    • New Mexico Medicaid Benefit Preauthorization Procedure Code List Update, Effective Oct. 1
    • Updates made to the Provider Reference Manual

     

    September 2022 — Read these articles and more...

    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective July 1, 2022 — Part 2
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Oct. 1, 2022 — Part 1
    • Coming Soon: IVR System to Offer Prior Authorization Requests for FEP® Members
    • Webinars on Cross-Cultural Care Offer Continuing Education Credit
    • Rehoboth McKinley Christian Suspending Labor & Delivery Services
    • Avoiding Antibiotics for Acute Bronchitis and Other Viruses
    • Are You Using These Shared Decision Making Aids?
    • Help Close Diabetes Disparity Gaps
    • Verify Your Directory Details Every 90 Days
    • Videos to Share on Behavioral Health Care
    • Reminders When Using the Claims Inquiry Resolution (CIR) Tool
    • Help Close Gaps in Care for Group Medicare Advantage Members
    • Reviews on Inpatient DRG Claims for BlueCard® (Out of Area) Medicare Advantage Members
    • Use Our New Prior Authorization Digital Lookup Tool for Medicaid Member Information
    • Updates made to the Provider Reference Manual

     

    August 2022 — Read these articles and more...

    • COVID-19 Information for Providers
    • Current Procedural Terminology® (CPT) Codes Updated for Prior Authorization for Medicare programs, Effective Oct. 1
    • Current Procedural Terminology® (CPT) Codes Updated for Prior Authorization, Effective Oct. 1
    • Provider Directory Locations — CMS Guidance
    • Reminder: It’s Time — Verify Your Directory Details
    • Reminder: Provider Access and Availability Survey
    • Pricing Information to Display Starting in July

     

    July 2022 — Read these articles and more...

    • COVID-19 Information for Providers
    • Updates made to the Provider Reference Manual
    • In home Test Kits for Colorectal Cancer Screening
    • Catch Up on Routine Vaccines and Well Child Visits
    • Provider Satisfaction Survey 2022
    • Provider Access and Availability Survey
    • Pricing Information to Display Starting in July
    • Provider Rights and Responsibilities
    • Member Rights and Responsibilities
    • CT Contrast Shortage
    • Flex and Open Access for Medicare Patients and Providers

     

    June 2022 — Read these articles and more...

    • COVID-19 Information for Providers
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective July 1, 2022 
    • Education Information Required for Directory
    • ClaimsXtenTM Quarterly Update Reminder
    • Current Procedural Terminology® (CPT) Codes Updated for Prior Authorization Effective July 1, 2022
    • BCBSNM to Recommend Preferred Drugs through Enhanced Prior Authorization
    • Behavioral Health Collaboration Requests
    • Closing Gaps in Diabetes Care
    • Earn Continuing Education Credit at Webinar on Avoiding Inappropriate Antibiotic Use
    • 2022 NM Annual NDC Drug Fee Schedule Impact and Timeline
    • Availity® Essentials Claim Status Tool Update
    • New ‘Message This Payer’ Option Coming via Availity Essentials
    • Current Procedural Terminology® (CPT) Codes Updated for Prior Authorization for Medicare programs, Effective July 1, 2022
    • Closing Gaps in Care for Group Medicare Advantage Members
    • Submit Multiple Clinical Claim Appeal Requests Online

     

    May 2022 — Read these articles and more...

    • COVID-19 Information for Providers
    • Avalon Training Reminder
    • Quality Measures: Prenatal and Postpartum Care
    • Q3 2022 Medicare Prior Authorization Code List Update
    • Gender Surgery Code Advisory
    • Follow-Up Care for Substance Abuse Disorders
    • Q2 2022 Prescription Changes
    • Credentialing Requirement for Facility-Based Providers

     

    April 2022 — Read these articles and more...

    • COVID-19 Information for Providers
    • Current Procedural Terminology® (CPT) Codes Updated for Prior Authorization
    • Free BH Webinars and Continuing Education Credit
    • Supporting Mental Health
    • Closing Gaps in Colon Care
    • ClaimsXten™ Quarterly Update Reminder
    • It’s Time — Verify Your Directory Details
    • CMS-Required Training for Dual-Special Needs Plans
    • Required Cultural Competency Training Available Online

     

    March 2022 — Read these articles and more...

    • COVID-19 Information for Providers
    • New Laboratory Management Program to Begin May 1, 2022
    • Differential Diagnoses of Depression: Free Webinar and Continuing Education Credit
    • 6x15 — Six Well-Child & Immunization Visits in the First 15 Months of Life
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Apr. 1, 2022 — Part 1
    • Delivering Quality Care: Supporting Healthy Hearts
    • Delivering Quality Care: Imaging Studies for Low Back Pain
    • Reminder: Claim Editing Enhancements Coming April 1
    • EXL Health Is Reviewing Complex Claims
    • Reminder: Blue Cross Community CentennialSM Prior Authorization Update for MSK Therapies (Rehab) Effective March 13, 2022, and Training Webinars
    • It’s Time — Verify Your Directory Details
    • Verify and Update Your Information Online via Availity® Provider Data Management
    • All Contracted Providers Will Now Display in Provider Finder®
    • New Medicare Advantage Flex (PPO) Plan — Questions and Answers for Providers
    • Closing Gaps in Care for Group Medicare Advantage Members
    • CMS Required Training for Dual Special Needs Plans
    • Required Cultural Competency Training Available Online

     

    February 2022 — Read these articles and more...

    • COVID-19 Information for Providers
    • Update — New Laboratory Policies and Laboratory Management Program Delayed
    • Chiropractic & Mixed Therapy Benefits Contained in IVR Phone System as of Jan. 3, 2022
    • 2021 Annual HEDIS® Medical Record Review Begins February 2022
    • Availity® Tools to Support Providers in 2022
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Jan. 1, 2022 — Part 2
    • Cervical and Breast Cancer Screenings
    • Reminder: Claim Editing Enhancements Coming in 2022, Register for a Training Webinar
    • ClaimsXtenTM Quarterly Update Reminder
    • Current Procedural Terminology (CPT®) Codes Updated for Prior Authorization for Commercial and Medicaid Members
    • Current Procedural Terminology (CPT®) Codes Updated for Prior Authorization for Medicare Members
    • Blue Cross Medicare Advantage Dual Care Plus (HMO SNP) — 2020 Program Summary
    • CMS Required Training for Dual Special Needs Plans
    • Required Cultural Competency Training Available Online
    • FEP Annual Medical Record Data Collection for Quality Reporting — HEDIS® Measurement Year (MY) 2021

     

    January 2022 — Read these articles and more...

    • COVID-19 Information for Providers
    • Current Procedural Terminology (CPT®) Codes Updated for Prior Authorization, Jan. 1, 2022
    • Behavioral Health Cost Share Waiver for Some BCBSNM Members Begins Jan. 1, 2022
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Jan. 1, 2022 — Part 1
    • Rural Health Clinics and Federally Qualified Health Centers May Meet Quality Measure
    • Webinar on Avoiding Antibiotics Overuse
    • Claim Editing Enhancements Coming April 1, 2022
    • Summary of 2022 FEP Benefit Changes
    • COVID 19 Vaccine Billing for Medicare Advantage Members
    • New Flexible Medicare Advantage PPO Plan
    • Patients in the Qualified Medicare Beneficiary Program Should Not Be Billed
    • Hospitals Must Provide Medicare Outpatient Observation Notice (MOON)
    • CMS Required Training for Dual Special Needs Plans
    • Required Cultural Competency Training Available Online

  • 2021

    December 2021 — Read these articles and more...

    • COVID-19 Information for Providers
    • Catch Up on Vaccines for All Ages
    • Information About the 2021 2022 Flu Season and Vaccination
    • Single Sign On Access to AIM Specialty Health® via Availity®
    • New Provider Designations and Services Forms for Provider Onboarding Applications
    • Watch for a Letter on Fighting Fraud, Waste and Abuse
    • Current Procedural Terminology (CPT®) Codes Updated for Prior Authorization (Commercial/Retail and Medicaid)
    • Current Procedural Terminology (CPT®) Codes Updated for Prior Authorization (Medicare)
    • Claim Editing Enhancements Coming Jan. 10, 2022
    • Including Behavioral Health Diagnoses on Claims and Referring to Behavioral Health Providers
    • View Withdrawn Claim Descriptions via the Availity Claim Status Tool
    • Reminder: Medicaid Providers Can Receive Payment for Project ECHO Consultations
    • Health Benefits of Collaborating with Eye Care Professionals
    • Hospital Discharge Summaries Are Important to Empower Members and Inform Specialists and Primary Care Providers
    • Reminder to Encourage Early and Timely Intervention for Pre- and Post-Partum Care Even Now
    • Our Medicaid Quality Improvement Program
    • CMS Required Training for Dual Special Needs Plans
    • Required Cultural Competency Training Available Online

     

    November 2021 — Read these articles and more...

    • COVID-19 Information for Providers
    • New Laboratory Policies Coming Jan. 1, 2022
    • 2022 Telemedicine Services
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Oct.1, 2021 — Part 2
    • Delivering Quality Care: Avoiding Antibiotics for Acute Bronchitis
    • Delivering Quality Care: Managing Diabetes
    • BCBSNM Moves to Streamline Coordination of Benefits for Members with Secondary Coverage
    • Introducing Electronic Clinical Claim Appeal Requests via Availity® Provider Portal
    • Initiation of Substance Use Disorder Provider Enhanced Payment Program — Blue Cross Community Centennial
    • Provider Incentive Program for Weight Assessment and Counseling for Children and Adolescents — Blue Cross Community Centennial
    • Surprise Billing Provisions of No Surprises Act
    • Provider Directory Information Verification
    • Continuity of Care Changes
    • New Information on Member ID Cards
    • Machine-Readable Files
    • CMS Required Training for Dual Special Needs Plans
    • Required Cultural Competency Training Available Online

     

    October 2021 — Read these articles and more...

    • COVID-19 Information for Providers
    • Coverage Replacement for Smoking Cessation Product CHANTIX® Due to Voluntary Recall
    • Reminder: Use AIM for Prior Authorization — Coming for Pharmacy Medical Oncology
    • Change to Some Primary and Secondary Claims Coordination
    • Documentation and Coding: Coding Cancer and Cancer-Related Treatments
    • Delivering Quality Care: Breast Cancer Screening
    • Are You Using These Shared Decision-Making Aids?
    • Reminder: Controlling High Blood Pressure
    • ClaimsXtenTM Quarterly Update Reminder
    • Earn CME/CEU Credit at Free Webinar on Comorbid Conditions
    • CMS-Required Training for Dual-Special Needs Plans
    • Enhanced Clinical Editing Processes Begin Jan. 1, 2022 for Blue Cross Community Centennial Claims
    • In-Home Diabetes Monitoring Tests Coming to Select Blue Cross Community Centennial Members
    • Required Cultural Competency Training Available Online

     

    September 2021 — Read these articles and more...

    • COVID-19 Information for Providers
    • Current Procedural Terminology (CPT®) Codes Updated for Prior Authorization
    • Documentation and Coding: Obesity and Morbid Obesity
    • Updates to Clinical Practice and Preventive Care Guidelines
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Oct. 1, 2021 — Part 1
    • Current Procedural Terminology (CPT®) Codes Updated for Prior Authorization for Medicare Programs
    • Availity® Claim Status Response Enhancement for Medicare Advantage Claims
    • CMS-Required Training for Dual-Special Needs Plans
    • Required Cultural Competency Training Available Online
    • Reminder: Update your Enrollment Information

     

    August 2021 — Read these articles and more...

    • COVID-19 Information for Providers
    • Prior Authorization Update – Pharmacy Medical Oncology
    • Behavioral Health Provider Access Standards
    • Adhering to HPV and Shingles Vaccine Guidelines
    • Delivering Quality Care: Antidepressant Medication Management
    • Colorectal Cancer Screening for Members Age 45 to 75
    • National Drug Code (NDC) Fee Schedule Changes Effective Sept. 1, 2021
    • CMS-Required Training for Dual-Special Needs Plans
    • Required Cultural Competency Training Available Online
    • Reminder: Update your Enrollment Information

     

    July 2021 — Read these articles and more...

    • COVID-19 Information for Providers
    • Coming Soon: View Professional Provider Fee Schedule via Availity®
    • Reminder: Current Procedural Terminology (CPT®) Codes Updated for Prior Authorization
    • Delivering Quality Care: Supporting Mental Health
    • Catch Up Now on Child and Adolescent Vaccinations
    • Earn CME/CEU Credit at Free Webinar on Opioid Use
    • In Home Test Kits for Colorectal Cancer Screening
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective July 1, 2021 — Part 2
    • Delivering Quality Care: Treating Substance Abuse
    • Provider Access and Availability Survey
    • Closing Gaps in Care for Group Medicare Advantage (MA) Members
    • Reminder: Current Procedural Terminology (CPT®) Codes Updated for Prior Authorization for Blue Cross Medicare AdvantageSM and Blue Cross Community CentennialSM Medicaid programs
    • CMS-Required Training for Dual-Special Needs Plans
    • Required Cultural Competency Training Available Online
    • Reminder: Update your Enrollment Information

     

    June 2021 — Read these articles and more...

    • COVID-19 Information for Providers
    • ClaimsXtenTM Quarterly Update Reminder
    • Current Procedural Terminology (CPT®) Codes Updated for Prior Authorization
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective July 1, 2021 — Part 1
    • BCBSNM Members Have New Mail Order and Specialty Pharmacies as of May 1, 2021
    • National Drug Code (NDC) Fee Schedule Change for Octagam (J1568)
    • Prepayment Reviews on Inpatient DRG Claims for BlueCard Members
    • EXL Health to Review Complex Claims July 1, 2021
    • Delivering Quality Care: Treating Substance Abuse
    • Current Procedural Terminology (CPT®) Codes Updated for Prior Authorization for Blue Cross Medicare AdvantageSM and Blue Cross Community CentennialSM Medicaid programs
    • CMS-Required Training for Dual-Special Needs Plans
    • Required Cultural Competency Training Available Online
    • Reminder: Update your Enrollment Information

     

    May 2021 — Read these articles and more...

    • COVID-19 Information for Providers
    • Some Codes Removed from AIM® Prior Authorization
    • Select Medication List to be Updated June 1, 2021
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective April 1, 2021 — Part 2
    • Documentation and Coding: Major Depressive Disorder
    • Delivering Quality Care: Cervical Cancer Screening May Save a Life
    • Delivering Quality Care: Caring for the Colon
    • Provider Satisfaction Survey 2021
    • New Applied Behavior Analysis (ABA) Service Request Forms
    • CMS-Required Training for Dual-Special Needs Plans
    • Required Cultural Competency Training Available Online
    • Reminder: Update your Enrollment Information

     

    April 2021 — Read these articles and more...

    • COVID-19 Information for Providers
    • Single Access Point for EFT and ERA Enrollments
    • Telehealth Place of Service Code Enabled
    • Health Care Quality: Blood Pressure Control – Speaking Out About the 'Silent Killer'
    • The CAHPS® Survey: We All Play a Role
    • Updates Made to the Provider Reference Manual
    • CMS-Required Training for Dual-Special Needs Plans
    • Required Cultural Competency Training Available Online
    • Reminder: Update your Enrollment Information

     

    March 2021 — Read these articles and more...

    • COVID-19 Information for Providers
    • BCBSNM will update CPT® Codes for some outpatient services, added benefits with AIM Specialty Health® (AIM) Effective April 1, 2021
    • CPT Category II Codes Can Help Close Care Gaps
    • Overpayment Recovery for Multiple Surgical Procedures
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective April 1, 2021, Part 1
    • CMS-Required Training for Dual-Special Needs Plans
    • Updates made to the Blue Cross Community Centennial Section of the BCBSNM Provider Reference Manual
    • Required Cultural Competency Training Available Online
    • Reminder: Update your Enrollment Information

     

    February 2021 — Read these articles and more...

    • COVID-19 Information for Providers
    • Documenting and Coding Guidance for Atrial Fibrillation
    • Documenting and Coding Guidance for Diabetes Mellitus
    • BCBSNM Federal Employee Program® Annual Medical Record Data Collection for Quality Reporting — HEDIS Measurement Year (MY) 2020 Begins Feb. 1, 2021
    • New HEDIS® Tip Sheets* Behavioral Health HEDIS Measures: FUA and FUM
    • Outpatient Provider Incentive Program for Behavioral Health Follow-up Visit
    • Childhood Immunization Rates Fall Amidst Pandemic Fears
    • Clinical Practice and Preventive Care Guidelines Updated for 2020-2021
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Jan.1, 2021 — Part 2
    • Coverage for Contraception Act
    • CMS-Required Training for Dual-Special Needs Plans
    • Required Cultural Competency Training Available Online
    • Reminder: Update your Enrollment Information

     

    January 2021 — Read these articles and more...

    • COVID-19 Information for Providers
    • Providers receiving bamlanivimab for free should not bill for the product
    • Reminder: Transition of Care: Preauthorization Changes from eviCore to AIM Specialty Health® (AIM) for Some Members effective Jan. 1, 2021
    • Reminder: Use the AIM ProviderPortal for Pre & Post Service Reviews
    • Annual HEDIS® Medical Record Review for Measurement Year 2020 to begin February 2021
    • BCBSNM will update CPT® codes for some outpatient services, added benefits with AIM
    • Quality Health Standards — Prenatal and Postpartum Visits
    • Medicare adds benefit for members with inherited ovarian or breast cancer
    • Hospitals Must Provide Medicare Outpatient Observation Notice (MOON)
    • Obtain BCBSNM Patient ID Numbers Online via Availity® — Now Available for Government Programs
    • Patients in the Qualified Medicare Beneficiary (QMB) Program Should Not Be Billed
    • Blue Cross Medicare Advantage Dual Care (HMO SNP) 2019 Program Summary
    • CMS Required Training for Dual Special Needs Plans
    • Coverage for Coronary Artery Calcium Scan for Cardiovascular Disease Risk Assessment
    • Required Cultural Competency Training Available Online

  • 2020

    December 2020 — Read these articles and more...

    • COVID-19 Information for Providers
    • BCBSNM Moving Preauthorization Duties from eviCore to AIM Effective Jan. 1, 2021, for Some Members
    • BCBSNM Preauthorization Changes Beginning Jan. 1, 2021
    • Revision to Specialty Medication Administration Site of Care Policy, Effective Jan. 1, 2021
    • Availity Claim Status Tool Now Available for All BCBSNM Members
    • Updates Made to the Provider Reference Manual
    • Billing Reminders for Psychological and Neuropsychological Testing
    • New HEDIS® Tip Sheets for Behavioral Health HEDIS Measures: APM and UOP
    • New Electronic Duplicate Claim Rejections for Commercial Claims Effective Nov. 14, 2020
    • Verify Multiple Patient's Eligibility and Benefits Coverage via Availity®
    • View, Download and Print the BCBSNM Member's ID Card Online via the Availity Provider Portal
    • Are Utilization Management Decisions Financially Influenced?
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Oct. 1, 2021, Part 1
    • Health Benefits of Collaborating with Eye Care Professionals
    • Importance of Hospital Discharge Summaries Both Empowers the Members and Informs Primary Care Providers
    • 2020 Reminder to Encourage Regular Pre- and Post-Natal Care
    • 2021 Blue Cross Medicare Advantage Preauthorization Updates
    • CMS-Required Training for Dual-Special Needs Plans
    • 2021 Blue Cross Community Centennial Prior Authorization Updates
    • Our Medicaid Quality Improvement Program
    • Required Cultural Competency Training Available Online

     

    November 2020 — Read these articles and more...

    • COVID-19 Information for Providers
    • Clinical Practice Guidelines for the Metabolic Syndrome and Management of Overweight and Obesity in Adults
    • Submit Electronic Professional and Facility Claims via the Availity® Provider Portal
    • Availity Provider Portal Offerings
    • Availity Claim Status Tool Now Available for All BCBSNM Members
    • Updates and Reminders: Submit Predetermination of Benefits Submission via Availity
    • Telemedicine — Future State
    • Are You Using These Shared Decision‑Making Aids?
    • BCBSNM Names New President
    • Provider Finder® Gets an Upgrade
    • CMS-Required Training for Dual-Special Needs Plans
    • Preparing for the 2020-2021 Flu Season: Administering Flu Vaccines During the COVID‑19 Pandemic
    • Required Cultural Competency Training Available Online

     

    October 2020 — Read these articles and more...

    • COVID-19 Information for Providers
    • In-Home Test Kits for Diabetics
    • Share Your Medication Assisted Treatment Designation
    • Blue Distinction® Message via the Availity® Eligibility and Benefits Results
    • Verify Procedure Code Preauthorization Requirements and Submit the Request via Availity
    • Outpatient Provider Incentive Program for Behavioral Health Follow‑up Visit
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Oct. 1, 2020, Part 2
    • Provider Finder® Gets an Upgrade
    • CMS-Required Training for Dual-Special Needs Plans
    • In-Home Diabetes Monitoring Tests Coming to Select Blue Cross Community CentennialSM Members
    • Required Cultural Competency Training Available Online

     

    September 2020 — Read these articles and more...

    • COVID-19 Information for Providers
    • Reminder for Billing Point-of-Use Convenience Kits
    • Submit Predetermination of Benefits Requests via Availity
    • iExchange Deactivated on Aug. 17, 2020
    • Two New Behavioral Health Measures Tip Sheets
    • Outpatient Provider Incentive Program for Behavioral Health Follow-up Visit
    • NMSU, BCBSNM Partner to Grow Health Care Workforce
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Oct. 1, 2020, Part 1
    • BCBSNM Medical Policies
    • Imaging Studies for Low Back Pain for FEP Members
    • CMS-Required Training for Dual-Special Needs Plans
    • Threshold Amount for Claims Review for Blue Cross Community Centennial Members
    • Required Cultural Competency Training Available Online

     

    August 2020 — Read these articles and more...

    • COVID-19 Information for Providers
    • Federal Agencies Extend Timely Filing and Appeals Deadlines
    • Colorectal Cancer Screening at Home
    • Overpayment Recovery Process for Contracted Providers – Changes as of Jan. 1, 2020
    • COVID-19 Coverage Updates for Medicare Providers
    • CMS Payment Adjustments for Medicare Providers
    • Blue Cross Medicare Advantage Prior Authorization Updates effective Sept. 1, 2020
    • Addition of New Prior Authorization Requirements for Blue Cross Community CentennialSM Members
    • CMS-Required Training for Dual–Special Needs Plans
    • Required Cultural Competency Training Available Online

     

    July 2020 — Read these articles and more...

    • COVID-19 Information for Providers
    • BCBSNM will update CPT Codes for some preauthorization Services
    • Are you submitting claims correctly for medications that come in additional packaging?
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective July 1, 2020 – Part 2
    • New Email Address for Prior Authorization Appeals Effective July 1, 2020
    • CMS-Required Training for Dual–Special Needs Plans
    • Required Cultural Competency Training Available Online

     

    June 2020 — Read these articles and more...

    • COVID-19 Information for Providers
    • Blue Cross and Blue Shield of New Mexico Contributes $1 million To Aid New Mexico's COVID-19 Response
    • Learn how to Submit a Prior Authorization through the eviCore Web Portal
    • Calls to Electronic Commerce Services will be Redirect to Email as of June 15, 2020
    • CMS-Required Training for Dual-Special Needs Plans
    • Required Cultural Competency Training Available Online

     

    May 2020 — Read these articles and more...

    • COVID-19 Information for Providers
    • Obtain your Provider Claim Summary (PCS) Online — PCS Mailing Discontinuation as of May 4, 2020
    • Remember to use In-Network Laboratories
    • Stand Up and Be Counted
    • CMS-Required Training for Dual-Special Needs Plans
    • New Annual Wellness Visit Resources for Medicare Providers
    • Required Cultural Competency Training Available Online

     

    COVID-19 Special Edition Blue Review - A digest of information for providers

     

    April 2020 — Read these articles and more...

    • Three New ClaimsXtenTM Rules to be Implemented June 2020
    • Obtain Your Provider Claim Summary (PCS) Online — PCS Mailing Discontinuation as of May 4, 2020
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective April 1, 2020, Part 1
    • CMS-Required Training for Dual-Special Needs Plans
    • CMS Star Ratings Matter: Survey to Assess Medicare Advantage Members’ Experiences
    • Required Cultural Competency Training Available Online
    • Telemedicine Grant Funding Opportunity for Contracted Providers
    • 2020 Centennial Care Performance Measures
    • Updates Made to the Blue Cross Community Centennial Section of the BCBSNM Provider Reference Manual

     

    February/March 2020 — Read these articles and more...

    • Two New ClaimsXtenTM Rules to be Implemented in 2020
    • New BCBSNM 837 Commercial Claim Validation Edits
    • Prior Authorization Changes for ID Prefixes BBE, BHP, BNK, BRG and BYR
    • Shared Decision Making Aids Available Online
    • Introducing a New Preauthorization Submission Tool via Availity® Provider Portal
    • 2020 Annual HEDIS® Medical Record Review Begins February 2020
    • CMS Required Training for Dual Special Needs Plans
    • Thank You: RADV/IVA Project 2019
    • Updates Made to the Medicare Advantage Section of the Provider Reference Manual
    • Required Cultural Competency Training Available Online
    • 2019 Medical Record Review
    • Pregnant Women and Vaccines

     

    January 2020 — Read these articles and more...

    • Two New ClaimsXtenTM Rules to be Implemented in 2020
    • New HEDIS® Behavioral Health Measures Tip Sheets
    • Reminder that Laboratory Benefit Level Changes for Some Members this Month
    • CMS-Required Training for Dual-Special Needs Plans
    • Reminder: Medicare Providers May Not Bill Participants in the Qualified Medicare Beneficiary Program
    • Medicare Advantage 30-Day Facility Readmissions Review
    • National Coordination of CareSM Program to Serve Group Blue Cross Medicare Advantage (PPO)SM Members
    • Annual Reminder: Medicare Outpatient Observation Notice Required
    • Updates Made to the Medicare Advantage Section of the Blues Provider Reference Manual
    • Required Cultural Competency Training Available Online
    • Changes to the HEDIS 2020 Prenatal and Postpartum Care Measure
    • Survey Shows Medicaid Members Give Their Providers High Ratings
    • Our Medicaid Quality Improvement Program

  • 2019

    December 2019 — Read these articles and more...

    • Coordinating Care Between Behavioral Health and Medical Providers
    • Referring Members to In-Network Laboratories
    • Availity® Remittance Viewer Tool Upgrade
    • New Online Enrollment Process for 835 EFT & ERA through the Availity Provider Portal
    • New Programs Help Members Lead Healthier Lives
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective January 1, 2020 – Part 2
    • Recommendations and Reminders for Eye Care Professionals
    • Information for Primary Care Providers – Importance of Hospital Discharge Summaries
    • CMS Required Training for Dual Special Needs Plans
    • 2019 Updates in Pre- and Post-Natal Care Information to Support Effective Coordination and Continuity of
    • Reminder of Change to the Preservice Appeals Process for your Medicare Patients Covered by BCBSNM
    • Medicare Advantage: Electronic Payment Summary Now Available for 835 ERA Receivers
    • Tips for Providing Reimbursable Telemedicine Services to BCBSNM Members
    • Blue Cross Community Centennial Quality Toolkit Updates

     

    November 2019 — Read these articles and more...

    • Antibiotic Use in Outpatient Settings
    • Collaborating to Reduce Opioid Abuse
    • Be Covered — Increasing Coverage for the Uninsured and Underinsured
    • What You Need to Know About the 2019-2020 Flu Season
    • Are Utilization Management Decisions Financially Influenced?
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective January 1, 2020 — Part 1
    • NDC Fee Schedule Change for Fulphila (J5108) and Udenyca (J5111) Effective January 1, 2020
    • Updates Made to the Provider Reference Manual
    • CMS Required Training for Dual Special Needs Plans
    • New Names and ID Cards for Group Medicare Plans
    • 2020 Blue Cross Medicare Advantage Preauthorization Updates
    • Billing and Documentation Guidelines for Urine Drug Tests
    • 2020 Blue Cross Community Centennial Prior Authorization Updates

     

    October 2019 — Read these articles and more...

    • HHS-RADV/IVA – Frequently Asked Questions
    • Addition of New Prior Authorization Requirements for New Mexico Members
    • A Change in the Coding of Physical Medicine Service Units: Time Based Measurement Standard to Follow AMA
    • Measure and Document Body Mass Index (BMI)
    • BCBSNM to Review Implant Claims from Stand Alone ASCs
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective October 1, 2019 — Part 2
    • Laboratory Benefit Level Change
    • CMS Required Training for Dual Special Needs Plans
    • Changes to Medicare Advantage Payment Models for Skilled Nursing Facility and Home Health Care Claims
    • Medicare PTAN and Medicaid Numbers/Letters Required for Network Inclusion
    • New Program Notification: Opioid Diagnosis Code Required at Pharmacy
    • Screening for Clinical Depression Initiative
    • Behavioral Health and Addiction TeleECHO Program

     

    September 2019 — Read these articles and more...

    • FEP Blue Focus Prior Authorization Reminder
    • New Online Case and Credentialing Status Checkers
    • New Addresses for Claims Overpayment Returns
    • Respond Electronically to medical Record Requests for Quality and risk Adjustment, and soon Claims, via Availity Provider Portal
    • Well–Child Visits Within the First 15 Months of Life (W15)
    • New and Exciting Functionality Coming to the Claim Research Tool (CRT) via Availity Provider Portal
    • IVR Phone System: Consolidated Benefit Response
    • Medicare Advantage Updates to Provider Finder Coming in September 2019
    • CMS–Required Training for Dual-Special Needs Plans

     

    August 2019 — Read these articles and more...

     

    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective July 1, 2019
    • Reminder: Verify Procedure Code Preauthorization Requirements Online
    • Member Letters Have a New, Simpler Look
    • CMS Required Training for Dual-Special Needs Plans
    • Notice of Change to Preservice Appeals Process for your Medicare Patients Covered by BCBSNM
    • Blue Cross Community CentennialSM Quality Toolkit Updates

     

    July 2019 — Read these articles and more...

     

    • Availity® Claim Research Tool Offers Enhanced Claim Status Results
    • Provider Signature Attestations for the HHS Risk Adjustment Data Validation Program
    • A Call to Immunize New Mexico Children
    • Changes to Behavioral Health Claim Review
    • Out of State Electronic Remittance Advice (ERA) Enrollment Notification
    • CMS Required Training for Dual-Special Needs Plans
    • Removal of Prior Authorization Requirements for your Medicare Advantage Patients
    • Automated Phone System Offers More Service Options for Medicare Advantage

     

    June 2019 — Read these articles and more...

    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective July 1, 2019
    • In–home Colorectal Cancer Screening Test Provided to Select Members
    • Screening and Treatment for Hepatitis C
    • Thank You for Participating in the HEDIS Medical Records Project
    • Helping Patients Shop for Cost-Effective Knee/Hip Replacements
    • Changes to Specialty Drugs Preauthorization List: Always Check Preauthorization Requirements
    • CMS–Required Training for Dual-Special Needs Plans
    • Reporting On-Demand Application Now Available for Government Programs via Availity® Provider Portal

     

    May 2019 — Read these articles and more...

    • BCBSNM is Continuing our Efforts to Validate Data for Our Provider Directories
    • Living365® "Living with Diabetes" Health Education Classes Available for All Blue Cross and Blue Shield of New Mexico Members
    • Imaging Studies for Low Back Pain
    • Making an Impact in Our Community
    • Check Eligibility and Benefits: Don't Skip This Important First Step!
    • May is Mental Health Month: Talk to Your Patients About Depression
    • BCBSNM Now Offers a Choice in Pharmacies for Specialty Medications
    • CMS-Required Training for Dual-Special Needs Plans

     

    April 2019 — Read these articles and more...

    • Changes to the Three-Character Prefix on Member ID Cards
    • Check you Patients’ Behavioral Health Preauthorization Requirements
    • Save Time by Using eviCore Web Portal for Preauthorization Requests
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective April 1, 2019
    • Medical records Request Reminder
    • Clinical Payment and Coding Policies
    • CMS-Required Training for Dual-Special Needs Plans
    • Change in Reject Notification for Invalid National Drug Codes (NDCs) Used on Electronic Medicare Advantage Claims

     

    March 2019 — Read these articles and more...

    • BCBSNM’s Payer Spaces Updates in Availity® Provider Portal
    • We Need Your Help to Improve Behavioral Health Care Access!
    • Referring Members to In-Network Laboratories
    • Clinical Payment and Coding Policies
    • Importance of Adult Body Mass Index (BMI) Measurement and Management
    • BCBSNM Will No Longer Accept Paper Onboarding Forms for Certain Provider Types Effective May 1, 2019
    • Are You Using These Shared Decision-Making Aids?
    • CMS-Required Training for Dual-Special Needs Plans
    • Annual Reminder: Medicare Outpatient Observation Notice (MOON) Required Training for Dual-Special Needs Plans
    • Government Programs: Verifying Claim Status in the Availity Provider Portal
    • Change in Preferred Hepatitis C Agent for Blue Cross Community Centennial Members, Effective March 1, 2019
    • 2019 HSD Behavioral Health Policy and Billing Manual and Supplement 19-04
    • 2019 Blue Cross Community Centennial Prior Authorization Updates

     

    February 2019 — Read these articles and more...

    • Pharmacy Program updates: Quarterly Pharmacy Changes Effective Jan. 1, 2019
    • We Need Your Help to Improve Behavioral Health Care Access!
    • 2019 Standards of Medical Care in Diabetes
    • Why Doctors Review Health Insurance Claims
    • Clinical Payment and Coding Policies
    • CMS–Required Training for Dual-Special Needs Plans
    • 2018 Medical Record Review
    • 2019 Blue Cross Community Centennial Prior Authorization Updates
    • Reminder: GuidingCare® is Now Available for New Mexico Medicaid Providers

     

    January 2019 — Read these articles and more...

    • Automated Phone system Change for Behavioral Health Services
    • Close HEDIS® Gaps Easily Through the Availity Provider Portal
    • Behavioral Health Forms Get a Facelift
    • 2019 Annual HEDIS medical Record Review Begins February 2019
    • Notification of Annual Benefit Updates
    • Clinical Payment and Coding Policies
    • CMS-Required Training for Dual-Special Needs Plans
    • New Opioid Drug Management Program for Medicare Members
    • New Concurrent Opioid and Benzodiazepine Prior Authorization Program for Blue Cross Community Centennial Members

  • 2018

    December 2018 — Read these articles and more...

    • 2019 Benefit Prior Authorization Changes: eviCore® Training, Reminders and Resources
    • Additional Clinical Payment and Coding Policies
    • Responding to Electronic Quality and Risk Adjustment Medical Record Requests via AvailityTM Provider Portal
    • Cardiology Services No Longer Require Prior Authorization for Blue Cross Medicare Advantage, Effective Dec. 17, 2018
    • Introducing FEP Blue FocusSM
    • Change in Preferred Diabetic Testing Supplies for Blue Cross Community CentennialSM Members, Effective Jan. 1, 2019
    • Performance Measure – Timeliness of Postpartum Care

     

    November 2018 — Read these articles and more...

    • Importance of Adult Body Mass Index Measurement and Management
    • BCBSNM Prior Authorization Changes Beginning Jan. 1, 2019
    • Specialty Pharmacy Infusion Site of Care: Prior Authorization Requirements
    • 2019 Blue Cross Community Centennial Prior Authorization Updates
    • Required Cultural Competency Training Available Online
    • Proper Claim Filing Procedures for Blue Cross Community Centennial Behavioral Health Providers
    • 2019 Blue Cross Medicare Advantage Prior Authorization Updates
    • Government Programs: Interpreting the ‘PLB’ Segment on the 835 Electronic Remittance Advice (ERA)
    • CMS-Required training for Dual-Special Needs Plans
    • FEP Benefits Changes for Infliximab Effective Jan. 1, 2019
    • Documentation During Pregnancy
    • Importance of Hospital Discharge Summaries
    • Referring Diabetic Patients for Annual Eye Exams

     

    October 2018 — Read these articles and more...

    • Prepping for the 2018-2019 Flu Season
    • New Application Process for Joining Out Networks
    • ‘Annual Visit’ Campaign Continues, Proper Coding is Crucial
    • Screening and Management for Clinical Depression
    • Important Reminder: Rendering, Ordering, Attending and Referring Providers Must Enroll with NM Medicaid for Blue Cross Community Centennial Claims

     

    September 2018 — Read these articles and more...

    • Quarterly Pharmacy Updates Effective July 1, 2018
    • Amniotic Membrane and Amniotic Fluid Products May Be Considered Experimental, Investigational and/or Unproven
    • Working Together To Improve The Member-Provider Experience: Member Concerns About Genetic Testing Costs And Coverage
    • New Lactation Consultation Designation Added To Demographic Change Form
    • New Application Process For Joining Our Networks
    • Important Reminder: Claims Will Deny If Rendering NPIs Are Not On File With BCBSNM
    • Important Reminder: Inpatient Services Require Prior Authorization 
    • Government Programs: Improving Claim-Related Processes and EDI Transactions
    • Tips for Providing Reimbursable Telemedicine Services to Blue Cross Community Centennial members
    • Important Reminder: Rendering, Ordering, Attending and Referring Providers Must Enroll with NM Medicaid for Blue Cross Community Centennial Claims

     

    August 2018 — Read these articles and more...

    • Appropriate Use of Opioids Program, Launched Aug. 1, 2018
    • Voluntary Recall of medications Containing the Valsartan Active Ingredient
    • Annual Visit Campaign Leads to Importance of Proper Coding
    • Making the Health Care System Work better Together
    • 2019 Blue Cross Centennial Care Contracts
    • New Mexico Medicaid Fee Schedule for Behavioral Health Providers Effective July 1, 2018

     

    July 2018  — Read these articles and more...

    • High-Dose Influenza Vaccine Guidelines
    • Working Together to Improve the Member-Provider experience: Member Concerns about “Up Front” Payments
    • Making the Health Care System Work Better Together
    • Annual Training for Medicaid Providers
    • CMS0Required Training for Dual-Special Needs Plans
    • Prohibition on Billing Dually Eligible Members Enrolled in the Qualified Beneficiary Program

     

    June 2018 — Read these articles and more...

    • Select Specialty Medications to Transition to Accredo Specialty Pharmacy
    • Addressing What Matters: How BCBSNM is Tackling the Opioid Crisis
    • V55 Claim Denial Resolution
    • HCPCS Mammogram Code Replacement
    • Reminder: Inpatient Services Require Prior Authorization
    • New eviCore Email Notification for Utilization Management Decisions
    • Quickly, Efficiently Manage and Respond to Coding Opportunities Online Through the Availity Provider Portal
    • Updates Made to Blue Cross Community Centennial Provider Reference Manual
    • Nursing Facility Bed Hold Days
    • Additional CLIA-Waived Codes

     

    May 2018 — Read these articles and more...

    • Quarterly Pharmacy Changes Effective Apr. 1, 2018
    • Services Rendered by Providers to Related Members and/or Self
    • Making the Health Care System Work Better Together
    • Member Concerns About DME – Working Together to Improve the Member-Provider Experience
    • Critical Incident Reporting
    • 2018 Billing and Documentation Guidelines for Urine Drug Tests

     

    April 2018 — Read these articles and more...

    • Updated Forms Available on Provider Website
    • Quickly Manage and Respond to Risk Gaps Through the Availity Web Portal
    • BCBSNM Approves Coverage of new Shingles Vaccine: Shingrix
    • Cancer Prevention: The Added Value in Adolescent Immunizations
    • Working Together to Improve the Member-Provider Experience: Choosing the Best Direction
    • Updated Online NDC Units Calculator Tool Now Available
    • Fall Prevention: Resources for Providers and members
    • Rendering, Ordering, Attending and Referring Provider Information Required for Blue Cross Community Centennial Claims
    • CareLink New Mexico Integrates Physical and Behavioral Health Services

     

    March 2018 — Read these articles and more...

    • Interpreting the “PLB” Segment on the 835 ERA
    • Making the Health Care System Work Better Together
    • Quarterly Pharmacy Changes Effective Jan. 1, 2018
    • March into Colon Cancer Awareness Month
    • Behavioral Health: Let’s Talk About It!
    • New Medicaid ID Numbers for Members

     

    February 2018 — Read these articles and more...

    • AvailityTM Claim Research Tool Offers Enhanced Claim Status Results
    • Electronic Commerce Services – Hours of Operation Update
    • BCBSNM Awarded Centennial Care 2.0 Contract
    • Hypertension: Resources for Providers and Members
    • Other Provider Resources

     

    January 2018 — Read these articles and more...

    • 2018 Holiday Schedule Reminders for 835 and 837 Transactions
    • Notice of Annual Benefit Updates
    • Pharmacy Benefit Tips
    • Online Magazine Spotlight: How Health Care Veterans Foster (and Learn from) Startups
    • Skilled Nursing Facility (SNF) Benefit Change for FEP Members

  • 2017

    December 2017 — Read these articles and more...

    • 2018 Additional Preauthorization Requirements
    • "Pulling It All Together" - Colon Cancer Screenings Goal: 80% Participation by 2018
    • Reimbursement Policy Update Effective Jan. 1, 2018
    • Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Oct. 1, 2017
    • 2018 Blue Cross Community CentennialSM Preauthorization Updates
    • Service Spotlight: Special Beginnings® Maternity Program
    • Updated Diagnosis Related Group Rates
    • New Dental Varnish Billing Code
    • Survey Shows Medicaid members Give Their Providers high Ratings
    • Looking Back at HEDIS®: Results for HEDIS 2015, 2016 and 2017
    • Our Medicaid Quality Improvement Program
    • Electronic Visit Verification (EVV) Claim Entries Require Supporting Documentation
    • 2018 Blue Cross Medicare AdvantageSM Preauthorization Updates
    • In-Home FOBT/FIT & HbA1c test Kits for FEP Members
    • 2018 FEP utilization Management Clinical Guideline 002: Inpatient Skilled Nursing Facility Care

     

    November 2017 — Read these articles and more...

    • 2018 HEDIS® Medical Record Review Begins February 2018
    • New medical Record Retrieval Vendor for Out-of-Area Blue Plan Member Records
    • New Online Magazine Spotlights Emerging Episodes of Care Payment Model
    • BCBSNM Celebrates LGBTQ Inclusion
    • Important Information on ABA Forms, Authorizations and Payment
    • Billing for Binaural Hearing Aids
    • How to Find BCBSNM Resources in AvailityTM Payer Spaces
    • Adhering to Vaccination Guidelines
    • Make Your Focus Clear on Eye Care with Retinopathy Screening
    • Important Notice Regarding Allergy Services
    • Documentation Guidelines for Laboratory Audit/Review
    • Operational Effectiveness: Better and Faster Ways to Do Business Together
    • National Diabetes Month 2017
    • Living 365SM Diabetes Education Classes
    • Cold Weather Asthma: Prevention Through Education
    • FEP Plan Update

     

    October 2017 — Read these articles and more...

    • Antidepressant Medication Management Initiative
    • Flu Vaccines, Billing, and CPT Codes
    • Examining Variability in Pricing Solutions Through Shared Data

     

    September 2017 — Read these articles and more...

    • BCBSNM Website
    • Adult BMI Assessment
    • Annual Well-Child Visit Important for Children and Caregivers
    • Identifying and Prescribing Correct Glucose Meter Test Strips
    • HSD No Longer Issuing Separate Medicaid Cards for MCO-Enrolled Members
    • Blue Cross Medicare Advantage: Electronic Claim Submission Edits
    • Government Programs: Claims Rejecting as Duplicate Submissions
    • Prohibition on Billing Dually-Eligible Members Enrolled in the Qualified Medicare Beneficiary Program

     

    August 2017 — Read these articles and more...

    • BCBSNM Website
    • Receipt of Credentialing Application Notification
    • ClaimsXtenTM Quarterly Updates
    • Code Auditing Enhancement
    • New Claim Payment and Remittance Resources
    • EFT and ERA Update for Non-Contracted Government Programs Providers
    • Integration of Prime Therapeutics® and Walgreens® Specialty Pharmacy and Mail-Order Services
    • Where Data Flows, Improvements are Bound to Follow
    • Blue Cross Community Centennial Changes, Effective July 21, 2017
    • Submitting Electronic Claims for Blue Cross Community Centennial Members
    • Pharmacy Change for blue Cross Community Centennial Members Effective Sept. 1, 2017
    • Antidepressant Medication Management Initiative

     

    July 2017 — Read these articles and more...

    • BCBSNM Website
    • ClaimsXtenTM Announces Software Version Upgrade
    • Utilization Management Determinations
    • Insurers Required by CMS to Conduct ACA Risk Adjustment Program Audit
    • Appointment Availability and Access Guidelines
    • Receipt of Credentialing Application Notification
    • Benefit Information Accessible in the IVR Phone System
    • Online Enrollment Options in AvailityTM
    • Additional Benefit Categories Contained in IVR Phone System
    • Careful Documentation Paves the Way for Accurate Coding Capture
    • Screening for Hepatitis C
    • Appointment Availability and Access Guidelines for Blue Cross Community Centennial Members
    • Blue Cross and Blue Shield of New Mexico Managed Care Program Blue Cross Community Centennial Changes, Effective May 20, 2017
    • Federal Employee Program Self-Measured Blood Pressure Monitoring
    • Member Rights and Responsibilities

     

    June 2017 — Read these articles and more...

    • BCBSNM Website
    • ClaimsXtenTM Announces Software Version Upgrade
    • Receipt of Credentialing Application Notification
    • Utilization Management Determinations
    • The Importance of Care Coordination
    • Insurers Required by CMS to Conduct ACA Risk Adjustment Program Audit
    • Benefit Information Accessible in the IVR Phone System
    • Online Enrollment Options in AvailityTM
    • Appointment Availability and Access Guidelines
    • Receipt of Credentialing Application Notification
    • Blue Cross and Blue Shield of New Mexico Managed Care Program Blue Cross Community Centennial Changes, Effective May 20, 2017
    • Member Rights and Responsibilities
    • Billing Medicaid Members
    • New Medicare Preauthorization Requirements through eviCore
    • Federal Employee Program Self-Measured Blood Pressure Monitoring

     

    May 2017 — Read these articles and more...

    • BCBSNM Website
    • ClaimsXtenTM Quarterly Updates
    • ClaimsXtenTM Announces Software Version Upgrade
    • Utilization Management Determinations
    • The Importance of Care Coordination
    • Insurers Required by CMS to Conduct ACA Risk Adjustment Program Audit
    • Benefit Information Accessible in the IVR Phone System
    • Online Enrollment Options in AvailityTM
    • Appointment Availability and Access Guidelines
    • Receipt of Credentialing Application Notification
    • Blue Cross and Blue Shield of New Mexico Managed Care Program Blue Cross Community Centennial Changes, Effective May 20, 2017
    • Member Rights and Responsibilities
    • Billing Medicaid Members
    • New Medicare Preauthorization Requirements through eviCore

     

    April 2017 — Read these articles and more...

    • BCBSNM Website
    • ClaimsXtenTM Quarterly Updates
    • Overcoming Barriers to Colorectal Cancer Screening
    • The Importance of Care Coordination
    • Insurers Required by CMS to Conduct ACA Risk Adjustment Program Audit
    • LifeTimes® Member Newsletter Offers Tips on Preventing Heart Attacks and Strokes
    • Appointment Availability and Access Guidelines
    • Provider Claim Summary Paper Mailing Discontinuance: Effective Date Delay
    • Receipt of Credentialing Application Notification
    • Member Rights and Responsibilities
    • Billing Medicaid Members
    • New Medicare Preauthorization Requirements through eviCore

     

    March 2017 — Read these articles and more...

    • ClaimsXtenTM Quarterly Updates
    • Kicking the Habit: Helping to Overcome Opioid Addiction in America
    • How are You Diagnosing Hypertension
    • AvailityTM Claim Research Tool Offers Enhanced Status Results
    • Talking with Health Services Staff
    • Utilization Management Determinations
    • Receipt of Credentialing Application Notification
    • Billing Medicaid Members
    • Member Rights and Responsibilities
    • New Medicare Preauthorization Requirements through eviCore

     

    February 2017 — Read these articles and more...

    • Annual Medical Record Data Collection for Quality Reporting begins February 1, 2017
    • Receipt of Credentialing Application Notification
    • 80% by 2018 Will you commit?
    • Preterm Labor Prevention Program
    • Additional Code-auditing Software Scheduled for Implementation as of April 30, 2017

     

    January 2017 — Read these articles and more...

    • Opiates
    • LARC use in Adolescents 15-19
    • BCBSNM Vision Plan Transitions to EyeMed - Revisions

  • 2016

    December 2016 Learn more about third-party links —  Read this article and more...

    • Avoiding Administrative Claim Denials
    • Coordination of Care Between Medical and Behavioral Health Providers
    • CMS Compliance Program Training Requirements
    • CVP Implementation Notice
    • Provider Payment and Provider Credentialing Requirement
    • Annual Medical Record Data Collection for Quality Reporting begins Feb. 1, 2017

     

    November 2016  — Read these articles and more…

    • ClaimsXtenTM Quarterly Updates
    • Welcome to Concussion Season
    • Flucelvax Quadrivalent Billing Update
    • Annual Medical Record Data Collection

     

    October 2016  — Read these articles and more…

    • Diabetes Coordination of Care and Blood Glucose Meter Program Updates
    • New Preauthorization Requirement for Applied Behavioral Analysis
    • Member Rights and Responsibilities
    • Special Beginnings® Maternity Program

     

    August 2016  — Read these articles and more…

    • CDC Guidelines for Prescribing Opioids for Chronic Pain
    • New Mexico Statewide Pharmacy Standing Order for Naloxone
    • Preventive Care Guidelines for Clinicians
    • Centennial Care Reminder - Update your Provider Enrollment Information

    Due to production delays, the Blue Review was not published in April through July. The monthly publication resumed in August 2016.

     

    March 2016  — Read these articles and more…

    • Correction - Telemedicine Reimbursement
    • Screening for Hepatitis C
    • Pediatric Asthma Intervention Project Results

     

    February 2016  — Read these articles and more…

    • New Products Offer More Choices and Potential Savings for BCBSNM Members
    • ICD-10 'Coding Basics' Video and Other Resources
    • Advance Directives — Not Just a Good Idea

     

    January 2016  — Read these articles and more…

    • Implementation Reminder: Three New Facility Rules for ClaimsXten™, Effective Feb. 22, 2016
    • Provider Medicare Enrollment Information
    • Reduction in Prior Authorization Requirements

Additional Information: