Claims inquiries? Call the Provider Service Unit (PSU) at 888-349-3706
Our PSU handles all provider inquiries about claims status, eligibility, benefits, and claims processing for BCBSNM members. For out-of-area claims inquiries, please call the BCBSNM BlueCard PSU at 800-222-7992.
Network Services contacts and related service areas
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Annual procedure code update
On Jan. 1, 2013, the Centers for Medicare & Medicaid Services (CMS), in conjunction with the American Medical Association (AMA) and the American Psychiatric Association (APA), issued major changes to CPT and HCPCS procedure codes. BCBSNM implemented these additions, deletions, and revisions, including the multiple changes to the behavioral health codes, effective Jan. 1, 2013. The new codes are based on the date of service, not the date the claim was submitted. Please note that the retired codes will not be accepted for payment for service dates on or after Jan. 1, 2013. For more information, visit the AMA website at ama-assn.org, or the APA website at psychiatry.org/practice.
Reimbursement for interpreter services
Some patients may need an interpreter while visiting your office. Contracted providers will need to provide an interpreter for limited English proficient individuals and interpretative services for patients who qualify under the Americans with Disabilities Act (ADA). Providers can arrange for the service using an interpreter service of their choice. Once the service is provided, the provider may submit an invoice for reimbursement to:
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Are you using the correct forms?
We periodically update the forms in the provider section of our website, so it’s important to check often to help ensure you are using the most current version. Forms are organized by category in our Education and Reference section.
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Submitting electronic replacement claims reminder
Electronically submitted replacement claims (also referred to as “corrected claims”) can reduce the possibility that a claim will deny as a duplicate. The BCBSNM claim system recognizes claim frequency codes on professional electronic claims. You can submit the appropriate electronic replacement code to indicate that the claim is an adjustment to a previously adjudicated electronic claim. Because the new claim will completely replace the previous claim, including all necessary details is essential.
For more information on professional electronic replacement claims and other claim filing tips, refer to the Claims and Eligibility section of our Provider website at bcbsnm.com/provider.
Enhancements in claims processing efficiency
In the third quarter 2013, BCBSNM will begin accepting partial batches, rejecting only individual claims that do not meet HIPAA compliance standards.
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