December 2023 — Read these articles and more...
- Updates Made to the Provider Reference Manual
- Chronic Kidney Disease Management Strategies for Primary Care Providers
- Reimbursement Rate Update for Some Commercial ABA Codes
- New Email Address for Electronic Commerce Services
- See Updates to Claim Editing Changes for Emergency Department Services
- Encourage Annual Eye Exams for Members with Diabetes
- Clinical Payment and Coding Policy Updates
- Training Resources for Behavioral Health Care
- Pharmacy Program Quarterly Update Changes Effective Jan. 1, 2024 — Part 1
- Updates Made to the Blue Cross Medicare Advantage Provider Reference Manual
- Medical Records Reminder for Out-of-Area Medicare Advantage Members
- Blue Cross Medicare Advantage Dual Care PlusSM 2022 Program Summary
- Blue Cross Medicare Advantage Dual Care Plus Preferred 2022 Program Summary
- Rate Increase for After Hours/Weekend Well Child Visits
- Updates Made to the Blue Cross Community Centennial Provider Reference Manual
- BCBSNM Will Open a Blue Door Neighborhood Center in the South Valley
November 2023 — Read these articles and more...
- Provider Finder® to Highlight ‘Top Performing Physicians’
- Join Us for a Webinar on Coding for Vascular Disease
- New CPT® Codes for COVID-19 Vaccines and Vaccine Administration
- Clinical Payment and Coding Policy Updates
- Coordinating Care after Hospital Discharges to Help Reduce the Chances of Readmissions
- What You Need to Know About the Flu Season
- Remember: New Enhancements for Behavioral Health Preservice Review Requests
- BlueApprovRSM Now Accepts Recommended Clinical Reviews for Behavioral Health — Attend a Training
- Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Oct. 1, 2023 – Part 2
- Musculoskeletal Category Expansion, Code Removals and other Prior Authorization Updates, Effective Jan. 1, 2024
- Medical Oncology, Radiation Oncology Care Category Removal from eviCore and other Prior Authorization Updates for Medicare Jan. 1
- Medicare Advantage Members to Transition to BCBSNM Kidney Care Program
- RSVP for 2023 Annual Medicaid Provider Training Sessions
- BCBSNM Will Implement a New Process for Member-Driven PCS Hour Decreases
- Temporary Economic Recovery Payment Increase for Home and Community Based Services — LOD #79-1
- Expiration of the Public Health Emergency — Prior Authorization for ABA Services
- Blue Cross and Blue Shield of New Mexico Teams Up With National Fitness Campaign to Bring Outdoor Fitness Courts Across New Mexico
October 2023 — Read these articles and more...
- BCBSNM Receives Notification of Intent to Award Turquoise Care Contract
- New Mailing Addresses for Paper Claims
- Updates made to the Provider Reference Manual
- ClaimsXtenTM Quarterly Update Effective Dec. 4, 2023
- Inpatient DRG claims for patients transferred early will be paid according to CMS’ transfer policy
- Reminder for Billing Point-Of-Use Convenience Kits
- Clinical Payment and Coding Policy Updates
- Updates to Clinical Practice and Preventive Care Guidelines
- BlueApprovRSM Now Accepts Recommended Clinical Reviews — Attend a Training
- Supporting Quality Care During Breast Cancer Awareness Month
- See New Enhancements for Behavioral Health Pre-service Reviews
- Select Medication List to be Discontinued
- Updates Made to the Blue Cross Medicare Advantage Provider Reference Manual
- Current Procedural Terminology (CPT®) Codes Updated for Prior Authorization for Medicare Oct. 1
- Survey Assesses Medicare Advantage Members’ Health Outcomes
- Updates Made to the Blue Cross Community Centennial Provider Reference Manual
- Blue Cross and Blue Shield of New Mexico Awarded NCQA Long-Term Services and Support Distinction
September 2023 — Read these articles and more...
- Transition from required Prior Authorization to Recommended Clinical Review Effective Sept. 18, 2023
- Reporting On-Demand via Availity® Essentials is Now Named Provider Claim Summary
- Shared Decision-Making Aids Can Help Guide Care Choices
- Claim Editing Changes for Emergency Department Services Coming Nov. 1, 2023
- Submitting Claims for Infertility Services
- Clinical Payment and Coding Policy Updates
- Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Oct. 1, 2023 — Part 1
- Medical Records Reminder for Out-of-Area Medicare Advantage Members
- Expiration of the Public Health Emergency
- New Mexico Medicaid Provider Engagement Forum
August 2023 — Read these articles and more...
- Updates made to the Provider Reference Manual
- Webinar on Coding for Morbid and Severe Obesity
- Introducing Claim Reconsideration Requests via Availity® Essentials
- Prior Authorization Codes Updated, Effective Oct. 1, 2023
- PEAQSM Physician Performance Insight Reports are Coming Soon
- In-Home Test Kits for Colorectal Cancer Screening
- Statin Therapy for Patients with Cardiovascular Disease and Diabetes
- See Our Revised Preventive Services Clinical Payment and Coding Policy Effective July 1, 2023
- Clinical Payment and Coding Policy Updates
- Direction from Centers for Medicare & Medicaid Services (CMS) regarding enrollment requirements for prescribing pharmacists or pharmacy providers under Medicaid
- Pharmacy Program Updates: Quarterly Pharmacy Changes Effective July 1, 2023 — Part 2
- Current Procedural Terminology (CPT®) Codes Updated for Prior Authorization for Medicare Oct. 1
July 2023 — Read these articles and more...
- Letter of Direction (LOD) #85 — Community Benefit Provider Audits
- Updates made to the Provider Reference Manual
- Webinars on Cross-Cultural Care Offer Continuing Education Credit
- Blue Community HMO NetworkSM (CNN) — Individual On and Off Exchange Plans
- New Availity® Eligibility & Benefits Experience
- Provider Access and Availability Survey
- Member Rights and Responsibilities
- Provider Rights and Responsibilities
- ClaimsXtenTM Announces Software Version Upgrade
- Catch Up on Routine Vaccines and Well-Child Visits
- Clinical Payment and Coding Policy Updates
- Prior Authorization Codes Updated, Effective July 1
- Current Procedural Terminology (CPT®) Codes Updated for Prior Authorization for Medicare and Medicaid Programs, July 1
- Blue Cross Medicare Advantage Dual Care Plus (HMO SNP)SM 2021 Program Summary
- Medicare Providers May Treat Medicare Advantage Flex and Group Medicare Advantage Open Access PPO Members
June 2023 — Read these articles and more...
- PEAQSM Provider Performance Insights Coming Soon
- BlueApprovRSM Expedites Medical Surgical, Pharmacy and Behavioral Health Prior Authorization — Attend a Training
- Coverage for Telemedicine Services when the Public Health Emergency Ends May 11
- Updates made to the Provider Reference Manual
- Earn Continuing Education Credit at a Webinar on Avoiding Inappropriate Antibiotic Use
- ClaimsXtenTM Quarterly Update Effective August 21, 2023
- 2023 NM Annual NDC Drug Fee Schedule Impact and Timeline
- Helping Our Members Manage Diabetes
- See our New Clinical Payment and Coding Policy for Outpatient Facility Services that Overlap During an Inpatient Stay
- Clinical Payment and Coding Policy Updates
- Members Can Now Access Network of Pharmacies at Accredited Cystic Fibrosis Treatment Centers
- Pharmacy Program Updates: Quarterly Pharmacy Changes Effective July 1, 2023
- Updates Made to the Blue Cross Medicare Advantage Provider Reference Manual
- Medical Records Reminder for Out-of-Area Medicare Advantage Members
- Updates Made to the Blue Cross Community Centennial Provider Reference Manual
May 2023 — Read these articles and more...
- BlueApprovRSM Expedites Medical Surgical, Pharmacy and Behavioral Health Prior Authorization — Attend a Training
- Updates made to the Provider Reference Manual
- Webinar on Coding for Chronic Kidney Disease
- Annual Regulatory Survey of BCBSNM Provider Directories
- Prior Authorization Codes Updated, Effective July 1, also watch for Medical Oncology Portal Enhancements
- Current Procedural Terminology (CPT®) Codes Updated for Prior Authorization for Medicare and Medicaid programs, July 1
- New Support Program for Members with Kidney Disease
- Track Care Visits During and After Pregnancy
- See our New Three-day Payment Policy for Outpatient Services Prior to an Inpatient Admission
- Clinical Payment and Coding Policy Updates
- Behavioral Health Consultations During Hospitalization Can Improve Outcomes
- Pharmacy Program Updates: Quarterly Pharmacy Changes Effective April 1, 2023 — Part 2
- 2022 Medical Record Review
April 2023 — Read these articles and more...
- AIM Specialty Health Changes Its Name to Carelon Medical Benefits Management
- BCBSNM Engaged Hospital Service Corporation for Site Visits
- Earn Continuing Education Credit through Webinar on Opioids
- See Changes to our Existing Inpatient Readmission Policy for Some Commercial Members
- Monitoring Children Using ADHD Medications
- Caring for Substance Use Disorders
- Screening and Follow-Up Care for Maternal Mental Health
- New for 2023: Specialty Pharmacies Added In-Network
- Pharmacy Program Updates: Quarterly Pharmacy Changes Effective January 1, 2023 — Part 2
March 2023 — Read these articles and more...
- New Blue ApprovRSM Expedites Some Prior Authorizations — Attend a Training to Learn More
- Updates made to the Provider Reference Manual
- Earn Continuing Education Credit through Webinar on Bipolar Disorder
- Cultural Awareness Webinars: Earn Continuing Education Credit
- Verify Your Directory Details Every 90 Days
- Provider Onboarding Form Requirement
- Closing Gaps in Colon Care
- Clinical Payment and Coding Policy Updates
- Quality Care: Screening for Depression
- Pharmacy Program Updates: Quarterly Pharmacy Changes Effective April 1, 2023 — Part 1
- Help Close Gaps in Care for Group Medicare Advantage Members
- Survey to Assess Medicare Advantage Members’ Experiences
- Updates Made to the Blue Cross Medicare Advantage Provider Reference Manual
- COVID-19 Public Health Emergency Ending
- New Mexico Human Services Department Issues Supplement #22-12
- Updates Made to the Blue Cross Community Centennial Provider Reference Manual
February 2023 — Read these articles and more...
- FEP® Annual Medical Record Data Collection for Quality Reporting — HEDIS®
- Updates made to the Provider Reference Manual
- Prior Authorization Codes Updated, Effective April 1
- Current Procedural Terminology (CPT®) Codes Updated for Prior Authorization for Medicare and Medicaid programs, April 1
- ClaimsXtenSM Quarterly Update Effective April 17, 2023
- Supporting Heart Health Equity
- Predetermination is now Recommended Clinical Review
- Clinical Payment and Coding Policy Updates
- Inflation Reduction Act to Impact Insulin and Vaccine Costs for Medicare Members
- Blue Cross Medicare Advantage Dual Care Plus (HMO SNP)SM 2020 Program Summary
- Updates Made to the Blue Cross Medicare AdvantageSM Provider Reference Manual
- Updates Made to the Blue Cross Community CentennialSM Provider Reference Manual
January 2023 — Read these articles and more...
- Prior Authorization Codes Updated, Effective January 1
- Current Procedural Terminology (CPT®) Codes Updated for Prior Authorization for Medicare programs
- Cervical and Breast Cancer Screenings
- Clinical Payment and Coding Policy Updates
- Patients in the Qualified Medicare Beneficiary Program Should Not Be Billed
- Hospitals Must Provide Medicare Outpatient Observation Notice
- Centennial Care Behavioral Health Screening Incentive Program
- Blue Cross Community Centennial Members Rate Their Experience
- Our Blue Cross Community Centennial Quality Improvement Program