Oct. 29, 2024
When you need to submit images to support a utilization management request, use the options below to send us photos. Photocopies sent via fax are typically low resolution and may not be reliable to support your case.
To support prior authorization or RCR requests initiated by phone or fax: Send photos via secured email. Add photos to your email as attachments, such as JPEG or PDF. (Don’t copy and paste photos into the body of your email.)
In the body of your email, include:
- Member’s first and last name
- Member’s date of birth
- Member ID number, including the three-character prefix
- Group number
- Case number from Blue Cross and Blue Shield of New Mexico
If you submitted your original utilization management request electronically: Send photos and other supporting documentation to us using the appropriate online option.
- BlueApprovRSM for prior authorization or RCR requests: For requests submitted via our BlueApprovR tool for some commercial members, we’ll email you to request photos if needed to complete clinical review. See our BlueApprovR provider tools page for more information.
- Availity® Essentials for prior authorization: Availity handles prior authorization requests for some of our commercial members. If a prior authorization request through Availity pends for clinical review, select “Add Clinical Documentation” to add up to 10 attachments (PDF, TIFF, JPEG or XML). See our Availity Authorizations provider tools page for more information.
- eviCore® healthcare for prior authorization (Medicare and Medicaid): Images can be attached in your prior authorization request on the eviCore portal. To upload images in eviCore, select “View Uploads, Letters and Faxes Tab” in the upper navigation menu.
- Carelon Medical Benefits Management for prior authorization: During the review Carelon may request diagnostic imaging results, such an X-ray, CT, MRI, etc., of the pertinent region performed within the last 12 months. Login to Carelon’s provider portal for more information.
Checking eligibility and/or benefit information and/or obtaining prior authorization is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage, including, but not limited to, exclusions and limitations applicable on the date services were rendered. If you have any questions, call the number on the member's ID card.
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. eviCore healthcare (eviCore) is an independent specialty medical benefits management company that provides utilization management services for BCBSNM. Carelon Medical Benefits Management is an independent company that has contracted with BCBSNM to provide utilization management services for members with coverage through BCBSNM. BCBSNM makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.