Blue Cross and Blue Shield of New Mexico (BCBSNM) continues to streamline the prior authorization process to reduce your workload with BlueApprovRSM. This new tool in Availity® Essentials expedites approvals for some medical and surgical, pharmacy drugs and behavioral health services for many of our commercial members.
BlueApprovRSM tool offers End-to-End Efficiencies
Registered Availity Essentials users have free, 24/7 access to BlueApprovR tool to:
- Request prior authorization for inpatient and outpatient medical surgical services, pharmacy drugs and behavioral health services
- Secure real-time approvals for certain services and begin treatment right away
- Easily attach medical records
- Check approval status of your request
Provider Training
You can attend an instructor-led, free webinar to learn how to use BlueApprovR. To register, select your preferred date and time from the list below. Times are Mountain Time:
- June 1, 2023 – 9 a.m. to 10 a.m.
- June 7, 2023 – 10 a.m. to 11 a.m
- June 8, 2023 – 9 a.m. to 10 a.m
- June 14, 2023 – 10 a.m. to 11 a.m
- June 15, 2023 – 9 a.m. to 10 a.m
- June 21, 2023 – 10 a.m. to 11 a.m
- June 22, 2023 – 9 a.m. to 10 a.m
- June 28. 2023 – 10 a.m. to 11 a.m
- June 29, 2023 – 9 a.m. to 10 a.m
Use BlueApprovR to Request Prior Authorization for these Types of Care
- Specialty Pharmacy
- Behavioral Health
- Inpatient Acute Care
- Long-term Acute Care
- Inpatient Rehab
- Skilled Nursing Facility
- Outpatient Hospice
- Home Health
- Outpatient Service
How to Submit Prior Authorization Requests through Availity Essentials
- In Availity, select Payer Spaces from the navigation menu, then BCBSNM
- On your Payer Spaces page, select the Applications tab and click BlueApprovR
- Users will be redirected to BlueApprovR to complete the request online
Other Prior Authorization Request Methods:
If you’re not a registered Availity Essentials user, register today on Availity.com. Otherwise, you may still request prior authorization with BCBSNM by calling the number on the member ID card.
Note: This new tool is currently not available for our Federal Employee Program®, Medicare Advantage or Blue Cross Community CentennialSM members. Please use your existing process for requesting prior authorization for these members.
Don’t forget – benefits will vary based on the service being rendered. Always check eligibility and benefits first for BCBSNM members to confirm if prior authorization is required. This step also will alert you if your request must be submitted through a vendor, rather than BCBSNM.
Provider Resources
Learn more about how to access and use BlueApprovR at our Provider Tools web page.
For More Information
Continue to watch News and Updates for future program updates and training opportunities.
Availity is a trademark of Availity, LLC, 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 third party vendors and the products and services they offer.