As a reminder, Blue Cross Medicare Advantage℠ plan providers who choose to opt out of Medicare should immediately notify their network representative with Blue Cross and Blue Shield of New Mexico. In compliance with Centers for Medicare & Medicaid Services policy, we are required to terminate providers from our Medicare Advantage networks if they’ve opted out of Medicare.
What it means to opt out
Opting out means that a provider has decided for a two-year period that they won’t participate in Original Medicare or Medicare Advantage Prescription Drug plans. If you opt out, you may not bill Medicare or Medicare Advantage plans for your services. Your decision to opt out is public on the CMS Opt-Out Dataset.
BCBSNM doesn’t contract with providers who have opted out of Medicare for our Medicare Advantage networks. In compliance with CMS policy, we may not pay providers who have opted out of Medicare for Medicare-covered services, except for emergency or urgent care services for our Medicare Advantage members who haven’t signed a private contract with you.
See the CMS website for more information. If you have questions, contact your network representative for BCBSNM.