Provider Training and Continuing Education

Join us for instructor-led webinar sessions on various Availity Essentials resources to learn about eligibility and benefits, prior authorization, BlueApprovR, claim status and other tools.  Learn more and register for training.

We offer the following free behavioral health webinars. Doctors (MDs and DOs), nurses, physician assistants and psychologists earn one continuing medical education credit for each course attended, unless otherwise noted. Social workers and mental health counselors (LPC, LCPC, LPCC, LMFT) earn one continuing education unit per course.

Continuing Education Credits: Recorded Webinars

Sign in (registration required) to view recordings of our previous webinars and earn CME/CEU credit: 

These courses are available:

• Bipolar Disorder: Diagnosis and Treatment, recorded February 2023 (1.5 CME/CEU)
• Comorbid Behavioral Health and Physical Health Conditions, recorded October 2021
• Depression in a Primary Care Setting, recorded June 2021
• Diabetes and Behavioral Health, recorded April 2022
• Differential Diagnoses of Depression: Assessment and Treatment, recorded March 2022
• Maternal Mental Health: Pregnancy and Postpartum, recorded April 2023 
• Opioid Use Disorder, recorded August 2021
• Pediatric Behavioral Health, recorded February 2024
• Social Determinants of Mental Health Care, recorded March 2024
• Substance Abuse: Coordinating Care and Improving Follow-Up, recorded May 2022
• Suicide Prevention with the Military Community, recorded November 2022 (1.5 CME/CEU)
• Synthetic Opioids and the Opioid Crisis, recorded April 2023

The webinars offer introductory training and a high-level overview.

_{The American Osteopathic Colleges of Ophthalmology and Otolaryngology-Head and Neck Surgery is accredited by the American Osteopathic Association to provide osteopathic continuing medical education for physicians. AOCOO-HNS designates this[SH1] program for a maximum of 1.0 AOA Category 1-A credits (or 1.5 where noted) and will report CME and specialty credits commensurate with the extent of the physician’s participation.}

_{Social Work CEUs Approved by NASW-NM. The Licensee must maintain proof of continuing education courses taken for the past four (4) years. The New Mexico Regulations and Licensing Department, Boards and Commissions, Social Work Licensing Board reserves the right to audit a licensee’s continuing education records as it deems necessary. This event has been approved for a total of 1 CEU (or 1.5 if noted).}

_{Physicians, nurses, physician assistants and psychologists can use AOA Cat 1-4 credit toward licensure. Social workers and mental health counselors (LPC, LCPC, LPCC, LMFT) can use the Social Work CEU credit toward licensure.}

_{The webinar material is for informational purposes only and is not intended to be a substitute for the independent medical judgment of a physician. Physicians and other health care providers are encouraged to use their own best medical judgment based upon all available information and the condition of the patient in determining the best course of treatment. References to other third-party sources or organizations are not a representation, warranty or endorsement of such organization.}

Attend free training sessions on how to submit requests for Carelon Prior Authorizations. Refer to the Carelon On-demand training page  for available sessions.

Join members of our Coding Compliance team for free webinars. They will present information from official coding resources to improve specificity and accuracy in coding, and help close gaps in patients’ care. Learn more about our coding webinars. 

In 2010, The Patient Protection and Affordable Care Act  reinforced the importance of the Model of Care (MOC) as a fundamental component of the Special Needs Plans quality improvement by requiring the National Committee of Quality Assurance to review and ensure the MOC meets requirements set by the Centers for Medicare & Medicaid Services.

The standards set by CMS requires all contracted and out-of-network providers seen by Dual-Special Needs Plan (D-SNP) members to receive an annual training on the D-SNP MOC. With the link provided, you will be able to view the attached course about the New D-SNP MOC and provide certification that you read the information upon completion. This is an annual requirement and a CMS reporting compliance requirement for Blue Cross and Blue Shield of New Mexico.

We are able to provide this course to you via a Cloud-based application called Brainshark. Upon clicking the BrainShark course link, you will see a pop-up with several fields to fill in. This is the BrainShark Guestbook, which is used to track and capture your basic user data for our proprietary use. We use this data to identify providers that have, and have not, completed this course.

The training should take approximately 20 minutes to complete. Please follow the listed steps to complete the D-SNP Brainshark course.

1. Visit BrainShark.
2. Completely fill out all fields in the BrainShark Guestbook and submit.
   Note: Please be sure to fill out the company name with the provider group name. Otherwise it makes reporting difficult without knowing with whom you are affiliated. 
3. Instructions are included at the end of the course on how to close out of the course so that you receive credit. We are asking all providers to please be diligent in completing the course on or before the deadline for CMS reporting compliance.

If you are not able to access the Brainshark link, use the link below to download the BrainShark DSNP MOC PowerPoint Training, and review in its entirety. Once complete, you can fill out the D-SNP MOC Attestation form and send to your assigned Provider Representative.

Related Resources:

• BrainShark DSNP MOC PowerPoint Training page
• D-SNP MOC Attestation form
• Provider Representative Contact List
• Frequently Asked Questions

The primary mission of BCBSNM Special Investigations Department (SID) is to identify, prevent, investigate, and stop potential fraudulent activities. The SID is committed to fighting fraud, reducing health care costs, and protecting the integrity of the BCBSNM provider network.

Each year billions of dollars are inappropriately spent due to health care fraud, waste, and abuse which contributes to the rising cost of health care for all Americans. In response to this problem, BCBSNM has an established SID – one of the most aggressive and effective health care fraud investigation programs in the industry.

To help you understand what health care fraud is, how it affects your practice, and how you can report health care fraud to the SID, BCBSNM offers a free online Fraud Awareness Training Tutorial.

BCBSNM considers fraudulent billing to include, but not be limited to:

• Deliberate misrepresentation of the services provided to receive payment for a non-covered service.
• Deliberately billing in a manner which results in a reimbursement greater than what would have been received if the claim was properly filed.
• Billing for services that were not rendered.

Additionally, the SID maintains a 24-hour fraud hotline, through which you can report any suspicions of fraud. All calls are confidential, and you may report your information anonymously. To file a report, call the hotline at 1-800-543-0867 (24/7) or go to bcbsnm.com/sid/reporting.

Related Resources:

• Health Care Fraud Prevention and Reporting

2019 Commercial and Medicare Plans Provider Training

2020 Medicare Provider Training

Annual Provider Training

Annual Provider Training is a requirement for all Medicaid providers. This information may be of interest and be beneficial for all providers. Please contact your <a href=">Provider Network Representative if you have any questions.

• 2023 Blue Cross Community Centennial Provider Orientation
  • 2023 Blue Cross Community Centennial - Behavioral Health Provider Training
  • 2023 Blue Cross Community Centennial - Long Term Services & Supports Provider Training
  • 2023 Blue Cross Community Centennial - Pregnancy-Related and Family Planning Services Provider Training
    
  • 2023 Blue Cross Community Centennial - Telehealth Provider Training
  • 2023 CMS and Albuquerque Area IHS Training
  • 2023 CMS and Navajo Nation IHS Training
  • 2023 Depression Screening and Outpatient Provider Incentive Overview
  • 2023 Home and Community Based Service (HCBS) Final Settings Rule Training
  • New Mexico Medicaid Centennial Care 2.0 Agency-Based Community Benefit Program Recruitment

Cultural Competency Training

Annual Cultural Competency Training is required by the New Mexico Human Services Department for all providers contracted within a New Mexico Medicaid network, like Blue Cross Community Centennial. Please have your 10-digit NPI number ready when starting the training or attestation below. Do not use any dashes or spaces when entering your NPI, and make sure your NPI is entered correctly before proceeding with the rest of the training or attestation.

• Cultural Competency Training
• Cultural Competency Training Attestation

Attend our free webinars on measures to track and improve our members’ care. Learn more about our quality improvement webinars and continuing education credits. 

BCBSNM is offering training on the Treatment and Supervision Documentation Guidelines for New Mexico Behavioral Health Medicaid providers.

• MCO Treatment and Supervision Documentation Training
• MCO Treatment and Supervision Documentation Checklist

Training Dates and Times

• March 8, 2024 – 11 a.m. to 12 p.m.
• March 27, 2024 – 2 to 3 p.m.
• June 7, 2024 – 11 a.m. to 12 p.m.
• June 26, 2024 – 2 to 3 p.m.