May 1, 2024
Electronic claim review through Availity® Essentials is fast and easy. If you’re unable to submit electronically, you can submit by paper using our Claim Review Form. Blue Cross and Blue Shield of New Mexico must have all the information requested to complete a proper claim review. Effective Aug. 1, 2024, we’ll return any incomplete form without conducting the claim review.
Here are some helpful tips when submitting a claim review form:
- These requests are only to be used for review of a previously adjudicated claim.
- Don’t attach the original claims to a review form, rather, you’ll reference the claim number in the appropriate field on the form
- Don’t use this form to submit a corrected claim, instead, use our Corrected Claim Form.
- Don’t use this form to respond to an additional information request. Use the Additional Information Request.
- If you submit this form as a request for a second review, you must provide information not previously submitted for the review to be eligible.
Reminder: Electronic submission is your fastest path to an efficient claim review at Availity® Essentials. Be sure to provide all required information as we won’t review electronic inquiries received with incomplete information.
Submit a Claim Review Online, Fast
To submit an online claim review request via Availity Essentials:
- First, perform a Claim Status search utilizing the Member or Claim tab
- Second, use the Dispute Claim or Message This Payer option to request a claim review
- Third, complete all needed information
More Information
Learn more at our Submitting Claims web page.
Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSNM. BCBSNM makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.