Q: How do I know which processes to follow for Cigna Healthcare Medicare Advantage customers and BCBSNM members?
A: When providing services to Cigna Healthcare Medicare Advantage customers and BCBSNM members:
- Ask to see the customer or member ID card before all appointments
- Check eligibility and benefits before all appointments
- Follow utilization management review requirements and guidelines
- Follow the billing instructions on the customer or member ID card
Q: Since BCBSNM Medicare business and Cigna Healthcare’s Medicare Advantage businesses will be joining together in early 2025, which medical policies, prior authorization and billing processes do I follow?
A: Following finalization of this transaction, you should not expect any changes to processes related to medical policies, prior authorization or billing processes as a result of the transaction. For BCBSNM members, follow current BCBSNM processes for providing and billing for care. For Cigna Healthcare Medicare Advantage customers, follow current Cigna Healthcare Medicare Advantage processes for providing and billing for care.
Q: Which provider manuals should I follow?
A: Follow BCBSNM provider manuals when caring for BCBSNM members. Follow Cigna Healthcare Medicare Advantage provider manuals when caring for Cigna Healthcare Medicare Advantage customers.
Q: Where do I submit claims?
A: Follow Cigna Healthcare Medicare Advantage claims submission processes for Cigna Healthcare Medicare Advantage customers and BCBSNM claims submission processes for BCBSNM members throughout 2025. We will provide you with information for 2026 at the appropriate time.
Q: Cigna Healthcare Medicare Advantage has a provider portal and BCBSNM uses Availity® Essentials. Will I need to get an Availity account?
A: Use the current Cigna Healthcare Medicare Advantage provider portal when caring for Cigna Healthcare Medicare Advantage customers, and use Availity Essentials when caring for BCBSNM members. We will provide you with information for 2026 at the appropriate time.