Member Rights and Responsibilities

As a participating provider, it’s important that you are aware of our members’ rights and responsibilities. A summary is provided below. Additional information can be found in the members’ benefit booklet and on our Member website.

Member rights include the right to:

  • Receive information about Blue Cross and Blue Shield of New Mexico (BCBSNM), our services, participating providers and facilities, and member rights and responsibilities
  • Be treated with respect and dignity with recognition of their right to privacy
  • Participate with providers in making decisions about their health care
  • Have a candid discussion of appropriate or medically necessary treatment options for their condition, regardless of cost or benefit coverage
  • Voice complaints or appeals about BCBSNM or the services we provide
  • Make recommendations regarding our members’ rights and responsibilities policy

Member responsibilities include a responsibility to:

  • Provide, to the extent possible, information that BCBSNM and the provider and facility need to provide care
  • Follow the plans and instructions for care that the member has agreed to with their provider
  • Understand their health problems and participate in the development of mutually agreed upon treatment goals, to the degree possible

Blue Cross and Blue Shield Federal Employee Program® (FEP®) members: In addition to the details provided above, visit fepblue.org for more information about our FEP members.