2010 changes affect claims filing for Walmart^® associates
Effective January 1, 2010, changes will alter the way you file claims for Walmart associates. BlueAdvantage^® Administrators of Arkansas will be the third-party administrator for all Walmart associates nationwide, including those previously administered by Blue Cross and Blue Shield of New Mexico (BCBSNM).

Transition instructions
Eligibility and precertification:

• To check eligibility and benefits after January 1, call 800-676-BLUE (2583) and provide the alpha prefix (WMW), or send an electronic eligibility inquiry (HIPAA transaction 270 online, Availity, etc.).
• If a service requires precertification, please use the designated telephone number on the back of the patient’s ID card.

Claims:

• Services provided to Walmart associates on or after January 1 for members previously administered by BCBSNM must be filed under the new BlueAdvantage ID member prefix, WMW, to prevent claim processing delays.
• Claims filed for 2009 services should be billed using the prefix MRT for BCBSNM.
  
• Claims should be filed through your local plan.
  
• Claim status may be obtained online (e.g., Availity) or by contacting your local Blues Plan.

ID cards:

• Please make copies of member ID cards for all Walmart associates at every visit during 2010 to ensure that claims are filed appropriately.
• New ID cards will be issued to all Walmart associates who previously had claims administered by BCBSNM. The effective date will be January 1, 2010. New ID cards will have the WMW prefix.

Behavioral health and mental health parity changes
BlueAdvantage administrators and Walmart have contracted with New Directions Behavioral Health to perform utilization management services.

Eligibility and precertification:

• To contact New Directions for precertification of behavioral health services, call 877-709-6822 or use the New Directions WebPass, which allows providers and office staff to submit precertification requests, contact Provider Relations, and update your online profile.
• To use New Directions WebPass, obtain a user name and password by downloading the Provider Internet WebPass Access Request Form. Fax the completed form to (913) 982-8227 or mail it to the address on the form. You will receive login information via e-mail within two business days of receipt of the form.

Outpatient behavioral health services:

• Eight visits for associates or family members may be provided without precertification or review.
• Psychiatric medication management does not require authorization.
  
• Precertification is required beginning with the ninth visit. New Directions will respond within 72 hours with authorization or a request for more information.

Inpatient, partial hospital, and intensive outpatient services:

• Contact New Directions for authorization of all inpatient, partial hospital, and intensive outpatient services: Call 877-709-6822 or use WebPass.