Reminder: Blue Medicare PPO claims submission requirements
As you know, BCBSNM exited the Medicare Advantage Program effective January 1, 2010. To ensure that providers’ claims are processed appropriately, we are providing this reminder. Please submit your claims as follows:

• Providers may use their own clearinghouses for claims submission; however, the Availity® Health Information Network is the front door for electronic claims submission into the Blue Medicare PPO claims processing system.
• The Payer ID for Blue Medicare PPO electronic claims submission is NMPPO.
  
• Electronic claims must be submitted as Medicare with receiver type C.
  
• The Blue Medicare PPO member ID alpha prefix is YID.
  
• Blue Medicare PPO claims must be submitted within 180 days of the date of service. Claims that are not submitted within 180 days from the date of service are not eligible for reimbursement. Blue Medicare PPO providers may not seek payment from the member for claims submitted after the filing deadline (except for applicable deductibles, copayments, or coinsurance amounts).
  
• Blue Medicare PPO paper claims must be submitted on the CMS-1450 or CMS-1500 and mailed to: Blue Medicare PPO, P.O. Box 3567, Scranton, PA, 18505.
  
• Both electronic and paper Blue Medicare PPO claims must be filed with the member’s complete ID number exactly as shown on the member’s ID card, including the prefix YID.
  
• The Blue Medicare PPO Provider Portal is no longer available after December 31, 2009. To obtain benefits and eligibility information and/or claims processing status, call Blue Medicare PPO Provider Customer Service at 866-706-7745.