December 2016

Provider Claim Summary Paper Conversion Coming March 1, 2017

Blue Cross and Blue Shield of New Mexico (BCBSNM) recognizes immediate access to the Provider Claim Summary (PCS) is vital for posting patient accounts and reconciling financials. Often times providers who receive this information via post office mail are waiting on delivery, which delays administrative processes.

As of Dec. 12, 2016, a new report viewer application will be available in the BCBSNM branded Payer Spaces section on the Availity Web portal. This new tool permits you to readily view, download, save and/or print the PCS online, as often as needed. This report viewer offers you the opportunity to obtain claim outcome results for multiple patients, in one central location.

Effective Mar. 1, 2017, claim summary information distributed via paper and postage will instead be delivered through this report viewer application. This alternative to mailing paper is an additional offering to our other online tools through Availity. If you currently rely on paper claim summaries, Availity registration is recommended to access the new application.

Providers who are already enrolled for Electronic Remittance Advice (ERA) will continue receiving their remittances electronically, but will also have the same opportunity to view, download, and/or print the claim summary as a complimentary option.

Exceptions to continue receiving paper mailing may be considered for extenuating circumstances. To submit this type of exception or request training for online applications, contact PECS@bcbsnm.com. Otherwise, beginning Mar. 1, 2017, claim summary information will be accessible exclusively on the report viewer application. Additionally, providers will be directed to make use of the BCBSNM report viewer application if an exception request is not received by Feb. 17, 2017. The review process may require up to 5 business days before a response is returned.

BCBSNM supports an array of online tools to registered Availity users, including the report viewer, at no additional cost. To register, simply go to availity.com, select “Register” and complete the online application today.

Additional communication regarding the above referenced change will be published in upcoming Blue Review editions and News & Updates postings, as well as our Provider website.

Availity is a trademark of Availity, L.L.C., a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSNM. BCBSNM makes no endorsement, representations or warranties regarding any products or services offered by third party vendors such as Availity. If you have any questions about the products or services offered by such vendors, you should contact the vendor(s) directly.