Resources

Check here for the most current versions of the newsletter dedicated to you and your health.

The Member Advisory Board (MAB) plays a key role in helping BCBSNM improve your Medicaid health plan. We want to know your experience with services you receive for behavioral health, physical health, long-term care and more. This board can include Turquoise Care members and their family. It can also include health care providers.

MAB meetings occur each quarter (4 times a year) in Albuquerque. There are also 2 statewide meetings each year. Please check the schedule for upcoming MAB meetings. There may be an option to call in or go online to the meeting if you cannot attend in person.

To learn more about MAB or to make a reservation, please call 1-866-825-6034 or email bcbs_ab@bcbsnm.com.

Native American Advisory Board

The Native American Advisory Board (NAAB) is a team like the MAB. But NAAB is a team that can advise BCBSNM on issues related to Native Americans. This can include issues with the health plan or services you receive. 

NAAB meetings are held each quarter (4 times a year). This board may include tribal representatives, Native American plan members and providers. Please check the schedule for upcoming NAAB meetings. There may be an option to call in or go online to the meeting if you cannot attend in person.

To learn more about NAAB or to make a reservation, please call 1-866-825-6034 or email bcbs_ab@bcbsnm.com.
 

Check the complete list of Member Rights and Responsibilities.

Advance health care directives are legal instructions. They include written instructions for health care and a power of attorney for health care.

These directives help if you become injured or too ill to make health care decisions on your own. Even though you may not be injured or ill now, you can decide how you want to handle these situations in the future.

Instructions for Health Care

These legal instructions state what to do if you become terminally ill or permanently unconscious. They say whether or not you want to be put on a life support system. They also say what kind of treatment you do and do not want. Instructions for health care are sometimes called a "Living Will."

Power of Attorney (POA) for Health Care

This power gives a person you choose the right to make health care decisions for you if you are unable to express your own wishes. This person should be someone you trust. Learn more about Advance Directives in your Member Handbook. Download a POA/Advance Health Care Directives form with instructions.

If you have questions, speak with your care coordinator or call BCBSNM at 1-866-689-1523. If you are speech or hearing impaired, call TTY 711. You can also call the State of New Mexico Aging and Disability Resource Center at 1-800-432-2080.

Other Resources

• End-of-Life Options Act – This state law was passed in 2021 to aid those who are terminally ill. It allows them to ask for help to die in peace if they choose. Learn more at the End-of-Life Options New Mexico website.
  
• End-of-Life Care for Those Who Have Cancer – Visit the National Cancer Institute website to find out why it is important to discuss what a loved one wishes before they are unable to do so.
  

At BCSBNM, we take great pride in helping you get the care you need. If you have a complaint about how we handle any service provided to you, you can file an appeal or a grievance. Learn more about appeals and grievances.

Health care fraud, waste and abuse have a negative effect on the health care industry and our nation. Health care fraud costs billions of dollars each year. It impacts all of us in the long run.

Health care fraud leads to:

• Higher health care costs
• Limited health care resources
• Lower consumer confidence in our health care system

Examples of health care fraud include billing for:

• A service that was never performed
• A more expensive service, supply or piece of equipment other than what was really provided
• The same service twice

We all need to work together to reduce health care fraud. Blue Cross and Blue Shield of New Mexico (BCBSNM) works to fight fraud with help from our:

• Members
• Providers
• Employer groups
• Producers
• Local, state and federal agencies and law enforcement

BCBSNM created the Special Investigations Department (SID) to fight fraud. The SID staff includes people from diverse backgrounds such as:

• Medical providers (doctors and nurses)
• Professional coders
• Insurance industry experts
• Law enforcement

SID also has a Data Intelligence Unit to partner with SID investigators to find and stop fraud, waste and abuse. When appropriate, SID refers fraud cases for criminal prosecution.

Check the fighting fraud checklist.

How do I report fraud?

If you suspect fraud, there are ways to report it.

• Report Online
  Complete a fraud report
  If you need to report fraud in Spanish or another language, please Report by Phone.
• Report by Phone
  1-800-543-0867
  The toll-free Fraud Hotline is available 24 hours a day, 7 days a week. You can remain anonymous. Or you can let us know if you want to be contacted.
• Report by U.S. Mail
  Blue Cross and Blue Shield of New Mexico
  Special Investigations Department
  5701 Balloon Fiesta Pkwy. NE
  Albuquerque, NM 87113

BCBSNM Medical Policies are based on scientific and medical research. They are often used as a guide to decide what is covered by a health plan. Medical Policies can relate to topics such as:

• Medical procedures
• Treatments
• Drugs
• Devices

BCBSNM puts these policies online. Medical Policies are not medical advice or care. They do not promise any results. BCBSNM does not give medical advice. BCBSNM does not provide health care. Independent health care providers are responsible for:

• Diagnosis
• Treatment
• Medical advice
  

Members may talk about Medical Policies with their health care providers. Members should always talk to their health care providers about any health questions or concerns. Review Medical Policies.